Provider Demographics
NPI:1679600159
Name:TAN-KANG, KEEHOON (LPC)
Entity Type:Individual
Prefix:MS
First Name:KEEHOON
Middle Name:
Last Name:TAN-KANG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KEEHOON
Other - Middle Name:
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:427 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5427
Mailing Address - Country:US
Mailing Address - Phone:972-293-8005
Mailing Address - Fax:972-293-8005
Practice Address - Street 1:427 OVERLAND TRL
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5427
Practice Address - Country:US
Practice Address - Phone:972-293-8005
Practice Address - Fax:972-293-8005
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional