Individual
YEN SHU CHANG XU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 ANDREW STILL CT APT 1082, DOTHAN, AL 36303-6346
(909) 618-7008
Mailing address
114 ANDREW STILL CT APT 1082, DOTHAN, AL 36303-6346
(909) 618-7008
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-65083
AL
Other
Enumeration date
09/29/2018
Last updated
09/29/2018
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