Provider Demographics
NPI:1366276487
Name:HU, YUANYUAN (MA)
Entity type:Individual
Prefix:
First Name:YUANYUAN
Middle Name:
Last Name:HU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:HU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2269 HEMLOCK CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2521
Mailing Address - Country:US
Mailing Address - Phone:734-678-4821
Mailing Address - Fax:
Practice Address - Street 1:3830 PACKARD ST STE 160
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2357
Practice Address - Country:US
Practice Address - Phone:734-929-9703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health