Provider Demographics
NPI:1114665874
Name:NI, ANPIN
Entity Type:Individual
Prefix:
First Name:ANPIN
Middle Name:
Last Name:NI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 STEWARTS CREEK DR APT 7
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-4100
Mailing Address - Country:US
Mailing Address - Phone:984-244-4773
Mailing Address - Fax:
Practice Address - Street 1:1708 OWEN DR
Practice Address - Street 2:PROFESSIONAL EARLY INTERVENTION SERVICES
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2830
Practice Address - Country:US
Practice Address - Phone:984-244-4773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30000650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist