Provider Demographics
NPI:1598071664
Name:NGUYEN, TERESA UYEN (MS, TLLP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:UYEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MS, TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 CHURCH ST
Mailing Address - Street 2:2229 EAST HALL
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1043
Mailing Address - Country:US
Mailing Address - Phone:714-235-0140
Mailing Address - Fax:734-615-0573
Practice Address - Street 1:530 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1043
Practice Address - Country:US
Practice Address - Phone:734-615-7853
Practice Address - Fax:734-647-1051
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014518390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program