Healthcare Provider Details

I. General information

NPI: 1003703836
Provider Name (Legal Business Name): YAN MI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23611 CHAGRIN BLVD STE 103
BEACHWOOD OH
44122-5540
US

IV. Provider business mailing address

2395 WOODMERE DR
CLEVELAND OH
44106-3653
US

V. Phone/Fax

Practice location:
  • Phone: 888-442-2323
  • Fax:
Mailing address:
  • Phone: 216-258-5029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2512441
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: