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General NPI Number Information
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NPI Number | 1467264150
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Entity Type | Individual
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Provider Name | SUZANNE CHANG LAC
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Gender | Female
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 368 MAIN ST
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City | CHATHAM
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State | NJ
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Zip | 07928-2112
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Country | US
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Telephone | 862-200-7218
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Fax |
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Provider Business Mailing Address
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Address Line | 152 GARFIELD PL
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1542
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Country | US
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Telephone | 856-287-1131
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37AC00850400
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License Number State | NJ
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