Provider Demographics
NPI:1689709743
Name:TRAN, KHANH (PSY,D)
Entity Type:Individual
Prefix:DR
First Name:KHANH
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PSY,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GOLDENEYE DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-9017
Mailing Address - Country:US
Mailing Address - Phone:307-670-9087
Mailing Address - Fax:
Practice Address - Street 1:632 COFFEEN AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5314
Practice Address - Country:US
Practice Address - Phone:307-655-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor