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General NPI Number Information
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NPI Number | 1912443995
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Entity Type | Organization
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Legal Business Name | PHUA'S COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 293 COMO AVE STE 200
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City | SAINT PAUL
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State | MN
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Zip | 55103-1842
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Country | US
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Telephone | 651-308-3120
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Fax |
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Provider Business Mailing Address
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Address Line | 529A OLD HIGHWAY 35
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City | HUDSON
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State | WI
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Zip | 54016-8144
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Country | US
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Telephone | 651-308-3120
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHUA YANG
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Credential | MSW, LICSW
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Telephone | 651-308-3120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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