Provider Demographics
NPI:1215408703
Name:LIU, HUAN-CHUNG SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:HUAN-CHUNG
Middle Name:SCOTT
Last Name:LIU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2257 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1373
Mailing Address - Country:US
Mailing Address - Phone:319-351-2526
Mailing Address - Fax:
Practice Address - Street 1:332 S LINN ST STE 14
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-244-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01006103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty