Provider Demographics
NPI:1033761820
Name:MANLUN, THONGCHIN LIAN (MA)
Entity Type:Individual
Prefix:
First Name:THONGCHIN
Middle Name:LIAN
Last Name:MANLUN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9922 S 66TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6203
Mailing Address - Country:US
Mailing Address - Phone:918-525-8148
Mailing Address - Fax:
Practice Address - Street 1:2448 E 81ST ST STE 2045
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4271
Practice Address - Country:US
Practice Address - Phone:918-600-2966
Practice Address - Fax:918-600-2965
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health