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General NPI Number Information
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NPI Number | 1720129984
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Entity Type | Individual
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Provider Name | THUY TRAN BOARDMAN PHD, MPH
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 10801 STARKEY RD STE 215
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City | SEMINOLE
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State | FL
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Zip | 33777-1161
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Country | US
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Telephone | 352-353-7916
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Fax |
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Provider Business Mailing Address
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Address Line | 11578 TRADEWINDS BLVD
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City | LARGO
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State | FL
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Zip | 33773-4416
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Country | US
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Telephone | 775-225-6421
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1633
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 12708
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License Number State | FL
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