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General NPI Number Information
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NPI Number | 1841762846
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Entity Type | Individual
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Provider Name | LYNZIE TINGLE CHANG
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Gender | Female
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 373 S WILLOW ST STE 266
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City | MANCHESTER
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State | NH
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Zip | 03103-5751
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Country | US
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Telephone | 877-315-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 2312 DURWOOD RD
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City | LITTLE ROCK
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State | AR
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Zip | 72207-3431
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Country | US
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Telephone | 501-313-5973
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-46960
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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