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General NPI Number Information
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NPI Number | 1184166985
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Entity Type | Individual
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Provider Name | KY VAN VUONG PSYD.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 18TH MEDICAL GROUP UNIT 5142
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City | APO
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State | AP
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Zip | 96368-5142
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Country | US
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Telephone | 544-634-3272
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 80 BOX 17449
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City | APO
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State | AP
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Zip | 96367-0077
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Country | US
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Telephone | 544-634-3272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-16-25581
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810007599
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License Number State | VA
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