Provider Demographics
NPI:1043461825
Name:TONG, RYAN (MSCP)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 HUNA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2456
Mailing Address - Country:US
Mailing Address - Phone:808-330-4329
Mailing Address - Fax:
Practice Address - Street 1:1720 HUNA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2456
Practice Address - Country:US
Practice Address - Phone:808-330-4329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health