Healthcare Provider Details

I. General information

NPI: 1336665660
Provider Name (Legal Business Name): HARRY CHIANG PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 W JEFFERSON AVE
LAKEWOOD CO
80235-2031
US

IV. Provider business mailing address

10136 NADINE AVE
PARKER CO
80134-7803
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-7673
  • Fax: 866-283-0595
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: