Healthcare Provider Details

I. General information

NPI: 1003720608
Provider Name (Legal Business Name): PEITING YU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17320 W 12 MILE RD STE 101
SOUTHFIELD MI
48076-2102
US

IV. Provider business mailing address

1525 NATALIE LN APT 305
ANN ARBOR MI
48105-2933
US

V. Phone/Fax

Practice location:
  • Phone: 248-727-3456
  • Fax: 248-557-4697
Mailing address:
  • Phone: 248-727-3456
  • Fax: 248-557-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122097
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: