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General NPI Number Information
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NPI Number | 1811910177
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Entity Type | Individual
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Provider Name | OLIVIA SHUN CHIANG PSYD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 6150 METROWEST BLVD STE 105
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City | ORLANDO
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State | FL
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Zip | 32835-3290
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Country | US
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Telephone | 321-842-6671
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Fax | 321-843-6447
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Provider Business Mailing Address
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Address Line | 6150 METROWEST BLVD STE 105
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City | ORLANDO
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State | FL
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Zip | 32835-3290
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Country | US
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Telephone | 321-842-6671
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Fax | 321-843-6447
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016540
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License Number State | NY
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