Provider Demographics
NPI:1164134235
Name:TSHIMANGA, GUY TSHILENGE
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:TSHILENGE
Last Name:TSHIMANGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7563 WITCH HAZEL DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7733
Mailing Address - Country:US
Mailing Address - Phone:614-589-1404
Mailing Address - Fax:
Practice Address - Street 1:7563 WITCH HAZEL DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7733
Practice Address - Country:US
Practice Address - Phone:614-589-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service