Provider Demographics
NPI:1568178127
Name:YA, TZY L
Entity Type:Individual
Prefix:
First Name:TZY
Middle Name:L
Last Name:YA
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 1:1523 SELBY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6304
Mailing Address - Country:US
Mailing Address - Phone:651-207-3019
Mailing Address - Fax:651-493-3914
Practice Address - Street 1:1523 SELBY AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6304
Practice Address - Country:US
Practice Address - Phone:651-207-3019
Practice Address - Fax:651-493-3914
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist