Healthcare Provider Details

I. General information

NPI: 1225764392
Provider Name (Legal Business Name): YUCHIAO HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 FELLAND RD STE 101-102
MADISON WI
53718-6461
US

IV. Provider business mailing address

601 W DOTY ST APT 211
MADISON WI
53703-2774
US

V. Phone/Fax

Practice location:
  • Phone: 920-857-9041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1017-140
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: