Organization
TIA WANG LLC
Active
Organization
TIA WANG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA WANG (OWNER)
(808) 258-9362
Entity
Organization
Contact information
Practice address
319 N CANE ST, WAHIAWA, HI 96786-2130
(808) 258-9362
Mailing address
PO BOX 987, HALEIWA, HI 96712-0987
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY-1281
HI
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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