Provider Demographics
NPI:1205284882
Name:LI, SIU-CHOU CATHERINE
Entity type:Individual
Prefix:
First Name:SIU-CHOU
Middle Name:CATHERINE
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIU-CHOU
Other - Middle Name:
Other - Last Name:AUYEUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:36 EDGEMERE RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2807
Mailing Address - Country:US
Mailing Address - Phone:973-422-0056
Mailing Address - Fax:
Practice Address - Street 1:36 EDGEMERE RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2807
Practice Address - Country:US
Practice Address - Phone:973-422-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033995-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker