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Individual

GAO TANG STANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 295-2609
Mailing address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 295-2609

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/03/2020
Last updated
03/03/2020
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