Provider Demographics
NPI:1770892101
Name:LU, CHIAJOU (MS)
Entity type:Individual
Prefix:
First Name:CHIAJOU
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 DEVONSHIRE ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1407
Mailing Address - Country:US
Mailing Address - Phone:781-817-3569
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST STE 500
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:781-817-3569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109391106H00000X
MA1444106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist