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General NPI Number Information
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NPI Number | 1033761820
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Entity Type | Individual
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Provider Name | THONGCHIN LIAN MANLUN MA
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Gender | Male
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 2448 E 81ST ST STE 2045
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City | TULSA
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State | OK
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Zip | 74137-4271
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Country | US
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Telephone | 918-600-2966
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Fax | 918-600-2965
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Provider Business Mailing Address
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Address Line | 9922 S 66TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74133-6203
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Country | US
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Telephone | 918-525-8148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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