Healthcare Provider Details

I. General information

NPI: 1912891466
Provider Name (Legal Business Name): WANSI HUANG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 E LA PALMA AVE
ANAHEIM CA
92806-2020
US

IV. Provider business mailing address

14724 SOFT WIND DR
NORTH POTOMAC MD
20878-4236
US

V. Phone/Fax

Practice location:
  • Phone: 301-590-5665
  • Fax:
Mailing address:
  • Phone: 301-590-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: