Provider Demographics
NPI:1114392008
Name:NGUYEN, LINDA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E RIVERSIDE DR
Mailing Address - Street 2:C406
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1108
Mailing Address - Country:US
Mailing Address - Phone:682-433-3757
Mailing Address - Fax:
Practice Address - Street 1:1300 E RIVERSIDE DR
Practice Address - Street 2:C406
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-1108
Practice Address - Country:US
Practice Address - Phone:682-433-3757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247000000X
TX1-16-21753103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information