Provider Demographics
NPI:1013642313
Name:TRUONG, XUAN
Entity Type:Individual
Prefix:
First Name:XUAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:XUAN
Other - Middle Name:T
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:721 GARDEN DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2998
Mailing Address - Country:US
Mailing Address - Phone:704-208-8323
Mailing Address - Fax:
Practice Address - Street 1:721 GARDEN DISTRICT DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2998
Practice Address - Country:US
Practice Address - Phone:704-208-8323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical