Provider Demographics
NPI:1609081439
Name:HUANG, GEORGE XU (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:XU
Last Name:HUANG
Suffix:
Gender:M
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9071 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3024
Mailing Address - Country:US
Mailing Address - Phone:626-286-5892
Mailing Address - Fax:626-286-5892
Practice Address - Street 1:9071 OLIVE ST
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3024
Practice Address - Country:US
Practice Address - Phone:626-286-5892
Practice Address - Fax:626-286-5892
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist