Provider Demographics
NPI:1215655071
Name:LE, MINDY HUYNH (PT, DPT)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:HUYNH
Last Name:LE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD STE S630
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3194
Mailing Address - Country:US
Mailing Address - Phone:504-340-6976
Mailing Address - Fax:504-834-8044
Practice Address - Street 1:1111 MEDICAL CENTER BLVD STE S630
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3194
Practice Address - Country:US
Practice Address - Phone:504-340-6976
Practice Address - Fax:504-834-8044
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
LA09388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist