Provider Demographics
NPI:1932487436
Name:NGUYEN, MAI-ANH (SLPA)
Entity Type:Individual
Prefix:
First Name:MAI-ANH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 N SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-7932
Mailing Address - Country:US
Mailing Address - Phone:480-242-6668
Mailing Address - Fax:
Practice Address - Street 1:2122 S 114TH LN
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-9184
Practice Address - Country:US
Practice Address - Phone:623-584-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA72302355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant