Provider Demographics
NPI:1922568062
Name:LI, DAN (PHD, LAC)
Entity Type:Individual
Prefix:MS
First Name:DAN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-1230
Mailing Address - Country:US
Mailing Address - Phone:240-821-2744
Mailing Address - Fax:
Practice Address - Street 1:4604 PINECREST OFFICE PARK DR.
Practice Address - Street 2:#G
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2231
Practice Address - Country:US
Practice Address - Phone:571-478-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500272171100000X
MDU02403171100000X
VA0121000911171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist