Provider Demographics
NPI:1043617962
Name:NGUYEN, THOMAS T (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 UNIVERSITY AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3435
Mailing Address - Country:US
Mailing Address - Phone:651-266-7999
Mailing Address - Fax:651-266-7850
Practice Address - Street 1:1919 UNIVERSITY AVE W STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104
Practice Address - Country:US
Practice Address - Phone:651-266-7999
Practice Address - Fax:651-266-7850
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5801103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical