Provider Demographics
NPI:1134589492
Name:LIU, YUEJIAO (CCC-SLP)
Entity type:Individual
Prefix:
First Name:YUEJIAO
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:YUEJIAO
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:45-002 LILIPUNA RD
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3018
Mailing Address - Country:US
Mailing Address - Phone:206-228-2277
Mailing Address - Fax:
Practice Address - Street 1:1377 AKAHAI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4117
Practice Address - Country:US
Practice Address - Phone:206-228-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-645103K00000X
HISP-1543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty