Provider Demographics
NPI:1083395842
Name:YANG, MING-SUEY IVY
Entity Type:Individual
Prefix:
First Name:MING-SUEY IVY
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 E LIVE OAK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5751
Mailing Address - Country:US
Mailing Address - Phone:785-979-1967
Mailing Address - Fax:
Practice Address - Street 1:4075 E LIVE OAK AVE STE B
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5751
Practice Address - Country:US
Practice Address - Phone:785-979-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist