Provider Demographics
NPI:1891927612
Name:NGUYEN, VIVIAN T (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 CHANUTE PL APT 3
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1159
Mailing Address - Country:US
Mailing Address - Phone:703-980-4825
Mailing Address - Fax:
Practice Address - Street 1:8001 CHANUTE PL APT 3
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1159
Practice Address - Country:US
Practice Address - Phone:703-980-4825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT11334225X00000X
WAOT60102700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist