Provider Demographics
NPI:1336203330
Name:ZHOU, GUANGWEI (SCD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:GUANGWEI
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:SCD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOPE AVE
Mailing Address - Street 2:WL1134
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-2741
Mailing Address - Country:US
Mailing Address - Phone:781-216-2790
Mailing Address - Fax:617-730-4829
Practice Address - Street 1:9 HOPE AVE
Practice Address - Street 2:WL1134
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2741
Practice Address - Country:US
Practice Address - Phone:781-216-2790
Practice Address - Fax:617-730-4829
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA690231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5100330Medicaid
MA5100330Medicaid