Provider Demographics
NPI:1316565435
Name:LI, SIQI
Entity Type:Individual
Prefix:
First Name:SIQI
Middle Name:
Last Name:LI
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 1:25 BRAINTREE HILL OFFICE PARK STE 400
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-8718
Mailing Address - Country:US
Mailing Address - Phone:774-893-3244
Mailing Address - Fax:
Practice Address - Street 1:25 BRAINTREE HILL OFFICE PARK STE 400
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-8718
Practice Address - Country:US
Practice Address - Phone:774-893-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical