Healthcare Provider Details

I. General information

NPI: 1356169577
Provider Name (Legal Business Name): XIAOYU ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 QUEEN ST
SOUTHINGTON CT
06489-1901
US

IV. Provider business mailing address

239 MILL ST STE B
WORCESTER MA
01602-3191
US

V. Phone/Fax

Practice location:
  • Phone: 860-518-5557
  • Fax: 888-200-4093
Mailing address:
  • Phone: 508-752-8466
  • Fax: 774-243-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: