Healthcare Provider Details

I. General information

NPI: 1750167565
Provider Name (Legal Business Name): ZEXI LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 UNION AVE, #157
MEMPHIS TN
38104-3725
US

IV. Provider business mailing address

10263 MARCH MEADOWS WAY
OLIVE BRANCH MS
38654-1586
US

V. Phone/Fax

Practice location:
  • Phone: 234-806-1966
  • Fax:
Mailing address:
  • Phone: 234-806-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1819
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-59884
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOBA.01251
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: