Healthcare Provider Details

I. General information

NPI: 1598627507
Provider Name (Legal Business Name): LI ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5054 DORSEY HALL DR STE 205
ELLICOTT CITY MD
21042-7796
US

IV. Provider business mailing address

9509 SEA SHADOW
COLUMBIA MD
21046-2059
US

V. Phone/Fax

Practice location:
  • Phone: 443-551-0888
  • Fax:
Mailing address:
  • Phone: 443-551-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM04961
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: