Provider Demographics
NPI:1194824250
Name:NGUI-YEN, AMANDA DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:DENISE
Last Name:NGUI-YEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44330 PREMIER PLZ
Mailing Address - Street 2:#110
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5070
Mailing Address - Country:US
Mailing Address - Phone:716-864-4802
Mailing Address - Fax:703-723-6647
Practice Address - Street 1:11495 SUNSET HILLS RD
Practice Address - Street 2:#100
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5256
Practice Address - Country:US
Practice Address - Phone:716-864-4802
Practice Address - Fax:703-723-6647
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03448111N00000X
VA0104556386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor