Healthcare Provider Details

I. General information

NPI: 1477984433
Provider Name (Legal Business Name): JU-PING HUANG PHD, L.P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 LONG LAKE RD STE 160
NEW BRIGHTON MN
55112-6414
US

IV. Provider business mailing address

3673 LEXINGTON AVE N H2 #252
ARDEN HILLS MN
55126-6414
US

V. Phone/Fax

Practice location:
  • Phone: 612-706-9630
  • Fax:
Mailing address:
  • Phone: 763-200-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP5957
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: