Provider Demographics
NPI:1689316754
Name:NGUYEN, PETER VIET (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:VIET
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SEAFORD CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4907
Mailing Address - Country:US
Mailing Address - Phone:804-467-6333
Mailing Address - Fax:
Practice Address - Street 1:3400 SEAFORD CROSSING DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4907
Practice Address - Country:US
Practice Address - Phone:804-467-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040138741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical