Provider Demographics
NPI:1740078138
Name:LIU, JUFANG (CF-SLP)
Entity type:Individual
Prefix:
First Name:JUFANG
Middle Name:
Last Name:LIU
Suffix:
Gender:
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 BLAISDELL AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3495
Mailing Address - Country:US
Mailing Address - Phone:507-613-1306
Mailing Address - Fax:
Practice Address - Street 1:2505 ANTHEM VILLAGE DR STE E579
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5505
Practice Address - Country:US
Practice Address - Phone:702-360-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist