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General NPI Number Information
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NPI Number | 1205694262
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Entity Type | Individual
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Provider Name | TRUONG SAN-NHI PHAM LPC
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Gender | Female
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 506 HONEA EGYPT RD STE 401
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City | MAGNOLIA
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State | TX
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Zip | 77354-2568
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Country | US
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Telephone | 346-637-4274
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 MYSTIC RIDGE CT
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City | MAGNOLIA
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State | TX
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Zip | 77354-7114
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Country | US
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Telephone | 832-317-4082
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86459
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 86459
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License Number State | TX
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