Provider Demographics
NPI:1700032992
Name:XU, QING (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:QING
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3519
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303-3519
Mailing Address - Country:US
Mailing Address - Phone:601-581-1191
Mailing Address - Fax:601-581-3292
Practice Address - Street 1:2221 HIGHWAY 39 N
Practice Address - Street 2:SUITE D
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-2636
Practice Address - Country:US
Practice Address - Phone:601-581-1191
Practice Address - Fax:601-581-3292
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist