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General NPI Number Information
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NPI Number | 1952703001
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Entity Type | Individual
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Provider Name | AMY YI-SHIUAN WU LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 10024 SKOKIE BLVD SUITE 311
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City | SKOKIE
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State | IL
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Zip | 60077-9944
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Country | US
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Telephone | 646-464-2556
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Fax |
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Provider Business Mailing Address
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Address Line | 8957 LAVERGNE AVE APARTMENT 1A
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City | SKOKIE
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State | IL
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Zip | 60077-1658
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Country | US
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Telephone | 646-464-2556
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Fax | 773-365-3093
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000964
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License Number State | IL
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