| NPI | 1770943128 |
|---|---|
| Former Name | JO SEP CHANG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088968) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL05626100) |
| Enumeration Date | 2016-02-27 |
| Last Update Date | 2022-01-25 |