Provider Demographics
NPI:1104539865
Name:NGUYEN, PHUONG THI (RN, LMSW, LCDC)
Entity type:Individual
Prefix:MRS
First Name:PHUONG
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RN, LMSW, LCDC
Other - Prefix:
Other - First Name:PHUONG
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, LMSW, LCDC
Mailing Address - Street 1:320 BRANARD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5014
Mailing Address - Country:US
Mailing Address - Phone:713-526-4444
Mailing Address - Fax:
Practice Address - Street 1:320 BRANARD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5014
Practice Address - Country:US
Practice Address - Phone:713-526-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1079231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical