Healthcare Provider Details

I. General information

NPI: 1093625055
Provider Name (Legal Business Name): NAOMI HUANG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47737 VAN DYKE AVE
SHELBY TOWNSHIP MI
48317-3372
US

IV. Provider business mailing address

47737 VAN DYKE AVE
SHELBY TOWNSHIP MI
48317-3372
US

V. Phone/Fax

Practice location:
  • Phone: 586-623-8030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122660
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: