Healthcare Provider Details

I. General information

NPI: 1144528472
Provider Name (Legal Business Name): YU-CHIEH CHANG MM, MT-BC, NMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EAST CURRY ROAD (NO MAIL HERE)
TEMPE AZ
85281
US

IV. Provider business mailing address

1710 S GILBERT RD, APT1035
MESA AZ
85204
US

V. Phone/Fax

Practice location:
  • Phone: 480-965-1082
  • Fax: 480-727-9697
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License NumberMT-BC09642
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: