Individual
ANDY XIONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2365 MCKNIGHT RD N, SAINT PAUL, MN 55109-2238
(651) 760-3236
Mailing address
2365 MCKNIGHT RD N, SAINT PAUL, MN 55109-2238
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G957095059421
MEDICAID AND PREMED
MN
Enumeration date
06/01/2020
Last updated
06/01/2020
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