Provider Demographics
NPI:1841780111
Name:HU, BOJUN
Entity Type:Individual
Prefix:
First Name:BOJUN
Middle Name:
Last Name:HU
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 1:15735 W LISBON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1000
Mailing Address - Country:US
Mailing Address - Phone:262-226-6932
Mailing Address - Fax:
Practice Address - Street 1:2 JIANGTAI RD, CHAOYANG QU
Practice Address - Street 2:
Practice Address - City:BEIJING
Practice Address - State:BEIJING
Practice Address - Zip Code:100096
Practice Address - Country:CN
Practice Address - Phone:105-927-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical