Healthcare Provider Details

I. General information

NPI: 1174728836
Provider Name (Legal Business Name): NGAN K VUONG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8014 STATE LINE RD STE 100
PRAIRIE VILLAGE KS
66208-3712
US

IV. Provider business mailing address

8014 STATE LINE RD STE 100
PRAIRIE VILLAGE KS
66208-3712
US

V. Phone/Fax

Practice location:
  • Phone: 913-432-2400
  • Fax:
Mailing address:
  • Phone: 913-432-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: