Healthcare Provider Details

I. General information

NPI: 1508712670
Provider Name (Legal Business Name): NGO MINH THUY NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 NW VIVION RD
KANSAS CITY MO
64118-4555
US

IV. Provider business mailing address

1435 COVENTRY MNR APT 104
LAWRENCE KS
66049-4644
US

V. Phone/Fax

Practice location:
  • Phone: 816-853-0946
  • Fax:
Mailing address:
  • Phone: 816-853-0946
  • Fax: 816-396-8809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-518045
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: