Healthcare Provider Details

I. General information

NPI: 1447870902
Provider Name (Legal Business Name): WEI SHAN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 S 108TH ST
WEST ALLIS WI
53227-3224
US

IV. Provider business mailing address

2443 N MURRAY AVE APT 307
MILWAUKEE WI
53211-4410
US

V. Phone/Fax

Practice location:
  • Phone: 414-885-3525
  • Fax:
Mailing address:
  • Phone: 608-322-9059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: