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General NPI Number Information
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NPI Number | 1124329065
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Entity Type | Individual
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Provider Name | ZOUA CHANG PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 393 DUNLAP ST N SUITE 450F
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City | SAINT PAUL
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State | MN
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Zip | 55104-4200
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Country | US
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Telephone | 612-756-8719
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Fax | 651-379-8752
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Provider Business Mailing Address
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Address Line | 3152 37TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2135
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Country | US
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Telephone | 612-756-8719
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Fax | 651-379-8752
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 5335
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License Number State | MN
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