Healthcare Provider Details

I. General information

NPI: 1518521236
Provider Name (Legal Business Name): KE LIU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3544 CHATHAM WAY
ANN ARBOR MI
48105-2828
US

IV. Provider business mailing address

3544 CHATHAM WAY
ANN ARBOR MI
48105-2828
US

V. Phone/Fax

Practice location:
  • Phone: 734-846-2259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015071
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19512
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: