Basic Information
| Provider Information | |||||||||
| NPI: | 1043617962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D., LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1919 UNIVERSITY AVE W STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551043435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512667999 | ||||||||
| FaxNumber: | 6512667850 | ||||||||
| Practice Location | |||||||||
| Address1: | 1919 UNIVERSITY AVE W STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512667999 | ||||||||
| FaxNumber: | 6512667850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2014 | ||||||||
| LastUpdateDate: | 11/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LP5801 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.