Provider Demographics
NPI:1205650033
Name:YANG, MAI LEE
Entity type:Individual
Prefix:
First Name:MAI LEE
Middle Name:
Last Name:YANG
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 1:13200 GLOBE DR STE 211
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1615
Mailing Address - Country:US
Mailing Address - Phone:262-258-2800
Mailing Address - Fax:
Practice Address - Street 1:13200 GLOBE DR STE 211
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1615
Practice Address - Country:US
Practice Address - Phone:262-258-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst