Provider Demographics
NPI:1699385906
Name:LIM, WEI XUAN
Entity Type:Individual
Prefix:MISS
First Name:WEI XUAN
Middle Name:
Last Name:LIM
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 1:5240 BABCOCK ST NE STE 105
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4615
Mailing Address - Country:US
Mailing Address - Phone:321-750-9803
Mailing Address - Fax:
Practice Address - Street 1:5240 BABCOCK ST NE STE 105
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4615
Practice Address - Country:US
Practice Address - Phone:321-750-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-69120103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst