Healthcare Provider Details

I. General information

NPI: 1033986740
Provider Name (Legal Business Name): MIAOMIAO HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N2305/241 HARBOUR ESPLANADE
DOCKLANDS VICTORIA
300821
AU

IV. Provider business mailing address

N2305/241 HARBOUR ESPLANADE
DOCKLANDS VICTORIA
300821
AU

V. Phone/Fax

Practice location:
  • Phone: 40-560-3518
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number096540
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: