Provider Demographics
NPI:1841759347
Name:DANG, MY TRINH H (SLP)
Entity Type:Individual
Prefix:MISS
First Name:MY TRINH
Middle Name:H
Last Name:DANG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 LONG BEACH BLVD STE 760
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2025
Mailing Address - Country:US
Mailing Address - Phone:562-317-5030
Mailing Address - Fax:
Practice Address - Street 1:4300 LONG BEACH BLVD STE 760
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2025
Practice Address - Country:US
Practice Address - Phone:562-317-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE12487390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program