Individual
JONATHAN Y TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
650 E INDIAN SCHOOL RD, COMMUNITY LIVING CENTER (CLC), PHOENIX, AZ 85012
(602) 277-5551
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
60814
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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