Provider Demographics
NPI:1093250045
Name:LIANG, QUN
Entity Type:Individual
Prefix:
First Name:QUN
Middle Name:
Last Name:LIANG
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 1:2586 CENTERGATE DR
Mailing Address - Street 2:APT 307
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7260
Mailing Address - Country:US
Mailing Address - Phone:954-864-0052
Mailing Address - Fax:
Practice Address - Street 1:50 TORCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2317
Practice Address - Country:US
Practice Address - Phone:954-290-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician