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Individual

SHENG BOUALONG LEE YANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
119 N MCCARTHY RD STE P, APPLETON, WI 54913-9112
(920) 903-1060
(902) 906-1164
Mailing address
5750 W GRANDE MARKET DR STE A, APPLETON, WI 54913-8406
(920) 903-1060
(902) 906-1164

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
8613-123
WI
1041C0700X
Clinical Social Worker
Primary
8613-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100042518
WI
Enumeration date
09/10/2014
Last updated
08/10/2022
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