Provider Demographics
NPI:1861158289
Name:YANG, HOUA (LPC-IT)
Entity type:Individual
Prefix:
First Name:HOUA
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 MAIN ST STE 510
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-0710
Mailing Address - Country:US
Mailing Address - Phone:608-796-1114
Mailing Address - Fax:608-615-1200
Practice Address - Street 1:319 MAIN ST STE 510
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-0710
Practice Address - Country:US
Practice Address - Phone:608-496-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5158-226103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy