Provider Demographics
NPI:1346986254
Name:YANG, MAY KOU
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:KOU
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 1:2417 HULDY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-6721
Mailing Address - Country:US
Mailing Address - Phone:651-757-0345
Mailing Address - Fax:
Practice Address - Street 1:29260 FRANKLIN RD STE 123
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1144
Practice Address - Country:US
Practice Address - Phone:248-701-9691
Practice Address - Fax:734-642-3458
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511144861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty