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General NPI Number Information
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NPI Number | 1235771312
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Entity Type | Organization
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Legal Business Name | WANG PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 596 EXECUTIVE PL STE 102
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5189
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Country | US
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Telephone | 910-758-1799
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Fax | 910-460-9659
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Provider Business Mailing Address
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Address Line | 596 EXECUTIVE PL STE 102
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5189
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Country | US
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Telephone | 910-758-1799
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Fax | 910-781-8700
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Authorized Official
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Title or Position | OWNER
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Name | MEI-CHUAN WANG
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Credential | PH.D.
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Telephone | 910-758-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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