Provider Demographics
NPI:1043610439
Name:LE, TUYET LAN V
Entity Type:Individual
Prefix:
First Name:TUYET LAN
Middle Name:V
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:V
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210B N GLEBE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3726
Mailing Address - Country:US
Mailing Address - Phone:703-589-4336
Mailing Address - Fax:703-522-7950
Practice Address - Street 1:210B N GLEBE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3726
Practice Address - Country:US
Practice Address - Phone:703-589-4336
Practice Address - Fax:703-522-7950
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA47-1746233253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care