Provider Demographics
NPI:1245541630
Name:VUE, BRYAN CHAO (LICSW)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:CHAO
Last Name:VUE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-4146
Mailing Address - Country:US
Mailing Address - Phone:651-771-1301
Mailing Address - Fax:651-771-2542
Practice Address - Street 1:2100 WILSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-4146
Practice Address - Country:US
Practice Address - Phone:651-771-1301
Practice Address - Fax:651-771-2542
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health