Healthcare Provider Details

I. General information

NPI: 1528891967
Provider Name (Legal Business Name): YUNZHUO LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3757 FISHCREEK RD
STOW OH
44224-5404
US

IV. Provider business mailing address

5333 FAWN CIR
KENT OH
44240-5611
US

V. Phone/Fax

Practice location:
  • Phone: 330-606-9262
  • Fax:
Mailing address:
  • Phone: 617-596-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number013041
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2403992
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: