Provider Demographics
NPI:1376653519
Name:NGUYEN-DRIVER, MINA DINH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:DINH
Last Name:NGUYEN-DRIVER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:THANH-VAN DINIH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 251418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1418
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:2575 GENE GEORGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-3180
Practice Address - Country:US
Practice Address - Phone:479-750-0125
Practice Address - Fax:479-750-0323
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1831103TC0700X
AR202187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical