Provider Demographics
NPI:1659393551
Name:CHUANG, YENKUEI (PHD)
Entity Type:Individual
Prefix:
First Name:YENKUEI
Middle Name:
Last Name:CHUANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 DAY ST
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-2921
Mailing Address - Country:US
Mailing Address - Phone:617-794-9591
Mailing Address - Fax:
Practice Address - Street 1:328 BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1840
Practice Address - Country:US
Practice Address - Phone:617-794-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY7653-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPY7653OtherSTATE LICENSURE NUMBER