Provider Demographics
NPI:1891212155
Name:TAI, YUCHUAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YUCHUAN
Middle Name:
Last Name:TAI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SEAMAN NECK RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8119
Mailing Address - Country:US
Mailing Address - Phone:213-479-1436
Mailing Address - Fax:
Practice Address - Street 1:134 SEAMAN NECK RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-8119
Practice Address - Country:US
Practice Address - Phone:213-479-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA14109977235Z00000X
NY2071454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor