Provider Demographics
NPI:1992336531
Name:KHUC, TIEN
Entity type:Individual
Prefix:
First Name:TIEN
Middle Name:
Last Name:KHUC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ELPHINSTONE STREET
Mailing Address - Street 2:
Mailing Address - City:DOOLANDELLA
Mailing Address - State:QUEENSLAND
Mailing Address - Zip Code:4077407
Mailing Address - Country:AU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1210 WILHELMINA RISE STE B
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3287
Practice Address - Country:US
Practice Address - Phone:808-260-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist