| Doctor Name: | DR. ROBERT S. CHANG |
| NPI Number: | 1144351586 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D., M.S.C.P. |
| License Number: | 1248 |
| Business Practice Address: | 318 Abolone Loop Mescalero, NM - 88340 |
| Business Phone Number: | 5754643827 |
| Business Fax Number: | |
| Mailing Address: | 318 Abolone Loop, MESCALERO |
| State: | NM |
| Postal Code: | 88340 |
| Phone Number: | 5754643827 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1248 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |