Provider Demographics
NPI:1770633406
Name:TANG, DEBBY T (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBBY
Middle Name:T
Last Name:TANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4912
Mailing Address - Country:US
Mailing Address - Phone:630-637-3884
Mailing Address - Fax:630-637-3884
Practice Address - Street 1:40 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4912
Practice Address - Country:US
Practice Address - Phone:630-637-3884
Practice Address - Fax:630-637-3884
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional