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General NPI Number Information
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NPI Number | 1457941874
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Entity Type | Individual
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Provider Name | LOYAL LUONG TRUONG
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Gender | Male
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 11 S ADAMS ST
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City | DENVER
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State | CO
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Zip | 80209-2909
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Country | US
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Telephone | 303-399-1146
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Fax |
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Provider Business Mailing Address
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Address Line | 1975 19TH ST APT 5013
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City | DENVER
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State | CO
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Zip | 80202-6081
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Country | US
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Telephone | 714-234-4631
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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 | SLP.0003871
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License Number State | CO
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