Individual
GRACE S YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 BUXTON FARM RD STE 105, STAMFORD, CT 06905-1210
(203) 674-8200
Mailing address
22 OLD KINGS HWY, NEW CANAAN, CT 06840-6413
(917) 520-4251
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1262
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/04/2018
Last updated
09/07/2021
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