Healthcare Provider Details

I. General information

NPI: 1487563417
Provider Name (Legal Business Name): VIVIAN MUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 STURGIS RD.
FPO AA
92278
US

IV. Provider business mailing address

13322 COPPER RIDGE RD
GERMANTOWN MD
20874-3455
US

V. Phone/Fax

Practice location:
  • Phone: 760-830-9120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: