Provider Demographics
NPI:1962957563
Name:NGUYEN, TRANG T MIMI (MHS)
Entity type:Individual
Prefix:
First Name:TRANG T MIMI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62200 WESTEND BLVD
Mailing Address - Street 2:APT 7303
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1615 POYDRAS ST
Practice Address - Street 2:SUITE 902
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1254
Practice Address - Country:US
Practice Address - Phone:504-648-6820
Practice Address - Fax:888-725-7090
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health