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General NPI Number Information
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NPI Number | 1356639025
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Entity Type | Individual
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Provider Name | KIM THIEN NGUYEN HO AU.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 200 S HERLONG AVE SUITE A
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City | ROCK HILL
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State | SC
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Zip | 29732-3399
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Country | US
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Telephone | 803-328-1864
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Fax | 803-328-1865
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Provider Business Mailing Address
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Address Line | 1330 BOILING SPRINGS RD STE 1400
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City | SPARTANBURG
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State | SC
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Zip | 29303-4205
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Country | US
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Telephone | 864-278-1442
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Fax | 864-278-1255
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 3981
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 10936
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License Number State | NC
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