Provider Demographics
NPI:1326826934
Name:LI, HUIJUN (MA, R-DMT)
Entity Type:Individual
Prefix:
First Name:HUIJUN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MA, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1493
Mailing Address - Country:US
Mailing Address - Phone:617-977-5372
Mailing Address - Fax:
Practice Address - Street 1:109 OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1493
Practice Address - Country:US
Practice Address - Phone:617-977-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist