Individual
DR. ETHAN TENG XIONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 789-6500
Mailing address
35 FOLLY ROAD BLVD UNIT 358, CHARLESTON, SC 29407-8314
(651) 492-8096
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
123456789
SC
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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