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General NPI Number Information
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NPI Number | 1639693625
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Entity Type | Individual
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Provider Name | JENNY NGUYEN SLP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 106 S JACKSON ST STE 1
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City | WAXAHACHIE
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State | TX
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Zip | 75165-3795
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Country | US
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Telephone | 972-938-2954
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Fax | 972-938-2946
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Provider Business Mailing Address
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Address Line | 750 FORT WORTH AVE APT 221
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City | DALLAS
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State | TX
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Zip | 75208-1832
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Country | US
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Telephone | 832-484-0487
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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 | 112436
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License Number State | TX
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