Provider Demographics
NPI:1811439052
Name:NGUYEN, AUDREY (LPC)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22310 GRAND CORNER DR.
Mailing Address - Street 2:SUITE 130
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22310 GRAND CORNER DR
Practice Address - Street 2:SUITE 130
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7468
Practice Address - Country:US
Practice Address - Phone:832-535-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health