Provider Demographics
NPI:1053762385
Name:TRIEU, EM
Entity type:Individual
Prefix:
First Name:EM
Middle Name:
Last Name:TRIEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1817
Mailing Address - Country:US
Mailing Address - Phone:508-791-4373
Mailing Address - Fax:
Practice Address - Street 1:484 MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1817
Practice Address - Country:US
Practice Address - Phone:508-791-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist