Provider Demographics
NPI:1245125590
Name:DU, YONGXUAN
Entity type:Individual
Prefix:
First Name:YONGXUAN
Middle Name:
Last Name:DU
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 1:615 S MAIN ST APT 132
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-3612
Mailing Address - Country:US
Mailing Address - Phone:734-489-3730
Mailing Address - Fax:
Practice Address - Street 1:615 S MAIN ST APT 132
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-3612
Practice Address - Country:US
Practice Address - Phone:734-489-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851120061104100000X
WASWIA.SC.61690299104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker