Provider Demographics
NPI:1225724156
Name:CHE, MENGYUAN
Entity type:Individual
Prefix:
First Name:MENGYUAN
Middle Name:
Last Name:CHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MENGYUAN
Other - Middle Name:
Other - Last Name:CHE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9036 E M 36
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-8147
Mailing Address - Country:US
Mailing Address - Phone:734-449-3320
Mailing Address - Fax:
Practice Address - Street 1:9036 E M 36
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-8147
Practice Address - Country:US
Practice Address - Phone:734-449-3320
Practice Address - Fax:888-976-6019
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511161221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical