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General NPI Number Information
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NPI Number | 1447978556
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Entity Type | Individual
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Provider Name | BAOTHU NGUYEN MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 9333 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-2812
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 10319 ECLIPSE CT
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City | GARDEN GROVE
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State | CA
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Zip | 92840-6320
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Country | US
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Telephone | 714-235-8786
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 33587
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License Number State | CA
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