Provider Demographics
NPI:1033881933
Name:YANG, TOU PHENG (MA)
Entity type:Individual
Prefix:MR
First Name:TOU
Middle Name:PHENG
Last Name:YANG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8451 E POINT DOUGLAS RD S # 30
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3331
Mailing Address - Country:US
Mailing Address - Phone:651-777-5222
Mailing Address - Fax:
Practice Address - Street 1:625 HAYWARD AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-7127
Practice Address - Country:US
Practice Address - Phone:651-327-0849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health