Provider Demographics
NPI:1538875240
Name:YEH, GRACE YUN-JUNG
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:YUN-JUNG
Last Name:YEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 POLAR LN STE 602
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3073
Mailing Address - Country:US
Mailing Address - Phone:408-802-3295
Mailing Address - Fax:
Practice Address - Street 1:3000 POLAR LN STE 602
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3073
Practice Address - Country:US
Practice Address - Phone:408-802-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist