Individual
LISA MEDINA NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2201 SE LOOP 820, FORT WORTH, TX 76119-5863
(817) 718-1080
Mailing address
9909 KEATHLY DR, FORT WORTH, TX 76131-2449
(817) 718-1080
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104758
TX
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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