Individual
VYVIAN PHAN
Active
Individual
VYVIAN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-11585
NM
1041C0700X
Clinical Social Worker
115372
TX
1041C0700X
Clinical Social Worker
Primary
SWB-2023-0980
NM
1041C0700X
Clinical Social Worker
X11642
NM
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/29/2017
Last updated
06/20/2026
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