Provider Demographics
NPI:1558130054
Name:TRAN, EILEEN THUY HONG
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:THUY HONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 PASS RD STE A
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2112
Mailing Address - Country:US
Mailing Address - Phone:228-828-3020
Mailing Address - Fax:718-865-5165
Practice Address - Street 1:2541 PASS RD STE A
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2112
Practice Address - Country:US
Practice Address - Phone:228-828-3020
Practice Address - Fax:718-865-5165
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician