Provider Demographics
NPI:1851653828
Name:WANG, YANJIE (MA)
Entity Type:Individual
Prefix:MS
First Name:YANJIE
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 FAUNCE CORNER RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1263
Mailing Address - Country:US
Mailing Address - Phone:774-206-1125
Mailing Address - Fax:
Practice Address - Street 1:145 FAUNCE CORNER RD
Practice Address - Street 2:SUITE K
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1263
Practice Address - Country:US
Practice Address - Phone:774-206-1125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health