Provider Demographics
NPI:1285870956
Name:WEN, XIAOLI (MS BCBA)
Entity type:Individual
Prefix:
First Name:XIAOLI
Middle Name:
Last Name:WEN
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9804 MADELAINE CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4918
Mailing Address - Country:US
Mailing Address - Phone:410-979-7999
Mailing Address - Fax:410-480-8281
Practice Address - Street 1:9804 MADELAINE CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4918
Practice Address - Country:US
Practice Address - Phone:410-979-7999
Practice Address - Fax:410-480-8281
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-05-2471103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst