Provider Demographics
NPI:1497449532
Name:YEOH, TZE YI (MA, LAC)
Entity Type:Individual
Prefix:
First Name:TZE YI
Middle Name:
Last Name:YEOH
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 E MAIN ST STE 111
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-9072
Mailing Address - Country:US
Mailing Address - Phone:480-388-4906
Mailing Address - Fax:928-888-1339
Practice Address - Street 1:1616 E MAIN ST STE 111
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-9072
Practice Address - Country:US
Practice Address - Phone:480-388-4906
Practice Address - Fax:928-888-1339
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-20842101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health