Healthcare Provider Details

I. General information

NPI: 1730848706
Provider Name (Legal Business Name): MRS. LIRONG ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date: 12/16/2021
Reactivation Date: 01/05/2022

III. Provider practice location address

130 ESSEX ST # 574
SOUTH HAMILTON MA
01982-2325
US

IV. Provider business mailing address

130 ESSEX ST # 574
SOUTH HAMILTON MA
01982-2325
US

V. Phone/Fax

Practice location:
  • Phone: 816-394-3701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: