Provider Demographics
NPI:1548003627
Name:LI, QINYI
Entity type:Individual
Prefix:
First Name:QINYI
Middle Name:
Last Name:LI
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 1:25 JAN KARSKI WAY APT D627
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-2776
Mailing Address - Country:US
Mailing Address - Phone:703-870-4727
Mailing Address - Fax:
Practice Address - Street 1:25 JAN KARSKI WAY APT D627
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-2776
Practice Address - Country:US
Practice Address - Phone:703-870-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health