Healthcare Provider Details

I. General information

NPI: 1902797087
Provider Name (Legal Business Name): TUYET-MAI T TRUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 TELEGRAPH RD
ST. LOUIS MO
63125
US

IV. Provider business mailing address

2870 TELEGRAPH RD
ST. LOUIS MO
63125
US

V. Phone/Fax

Practice location:
  • Phone: 636-633-2618
  • Fax:
Mailing address:
  • Phone: 636-633-2618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: