Provider Demographics
NPI:1558866236
Name:BI, XIAOTING
Entity Type:Individual
Prefix:
First Name:XIAOTING
Middle Name:
Last Name:BI
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 1:250 E WYNNEWOOD RD APT G8
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1505
Mailing Address - Country:US
Mailing Address - Phone:215-920-0811
Mailing Address - Fax:
Practice Address - Street 1:2317 S 23RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-3329
Practice Address - Country:US
Practice Address - Phone:215-468-4673
Practice Address - Fax:215-468-4673
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional