| Holly F Nguyen Therapy Llc | |
|
1901 N Moore Ave Ste 15 Moore OK 73160-3612 | |
| (405) 701-9333 | |
| Not Available |
| Full Name | Holly F Nguyen Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1901 N Moore Ave Ste 15, Moore, Oklahoma |
| Authorized Official Name and Position | Holly Rae Forster-nguyen (OWNER) |
| Authorized Official Contact | 4057019333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holly F Nguyen Therapy Llc 1901 N Moore Ave Ste 15 Moore OK 73160-3612 Ph: (405) 701-9333 | Holly F Nguyen Therapy Llc 1901 N Moore Ave Ste 15 Moore OK 73160-3612 Ph: (405) 701-9333 |
| NPI Number | 1275154304 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 09/17/2021 |
| Certification Date | 09/17/2021 |
| Medicare PECOS PAC ID | 7719318237 |
|---|---|
| Medicare Enrollment ID | O20200515001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275154304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Holly R Forster Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235449695 PECOS PAC ID: 9032540554 Enrollment ID: I20200515001450 |
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