Provider Demographics
NPI:1881844793
Name:NGUYEN, MAI HUYNH
Entity Type:Individual
Prefix:MRS
First Name:MAI
Middle Name:HUYNH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MAI
Other - Middle Name:HUYNH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:339 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2618
Mailing Address - Country:US
Mailing Address - Phone:504-373-6443
Mailing Address - Fax:
Practice Address - Street 1:339 TERRY PKWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-2618
Practice Address - Country:US
Practice Address - Phone:504-373-6443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07089OtherPHYSICAL THERAPY LICENSE IN LOUISIANA