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NPI Code Detail

MEDICARE: MRS. PHUONG NGUON-LE LCSW

MEDICARE: MRS. PHUONG NGUON-LE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker5158951-3501UT

General Provider Information

NPI Number : 1831169341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PHUONG NGUON-LE LCSW
Provider Business Mailing Address
First Line : 4834 TAYLORS HILL DR
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-4729
Country : US
Telephone Number : 801-262-2895
Fax Number :
Provider Business Practice Location Address
First Line : 3944 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107-1600
Country : US
Telephone Number : 801-261-1442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 12/18/2009

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