Provider Demographics
NPI:1811777899
Name:WANG, JOSEPH S
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:WANG
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 1:2120 SAINT JAMES AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2689
Mailing Address - Country:US
Mailing Address - Phone:832-692-1286
Mailing Address - Fax:
Practice Address - Street 1:11085 MONTGOMERY RD STE 250
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2395
Practice Address - Country:US
Practice Address - Phone:513-547-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service