Healthcare Provider Details

I. General information

NPI: 1437803491
Provider Name (Legal Business Name): ANNA THU PHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N CAUSEWAY BLVD STE 201
METAIRIE LA
70002-7215
US

IV. Provider business mailing address

38105 POST OFFICE RD STE 8
PRAIRIEVILLE LA
70769-4296
US

V. Phone/Fax

Practice location:
  • Phone: 504-218-5657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC11506
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: