Provider Demographics
NPI:1184699696
Name:WANG, LIZHAO (PHD)
Entity type:Individual
Prefix:
First Name:LIZHAO
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:5634 SW CLARION LAKES DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66610-1627
Mailing Address - Country:US
Mailing Address - Phone:785-232-8542
Mailing Address - Fax:785-478-1791
Practice Address - Street 1:1504 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1632
Practice Address - Country:US
Practice Address - Phone:785-232-8542
Practice Address - Fax:785-478-1791
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-18
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KSLP830103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist