Healthcare Provider Details

I. General information

NPI: 1679742878
Provider Name (Legal Business Name): YAN Q HUO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 WASHINGTON AVE
PHILADELPHIA PA
19147-3840
US

IV. Provider business mailing address

432 N 6TH ST
PHILADELPHIA PA
19123-4004
US

V. Phone/Fax

Practice location:
  • Phone: 267-242-6284
  • Fax:
Mailing address:
  • Phone: 267-242-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004265
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPC004265
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: