Provider Demographics
NPI:1447482047
Name:STYN, MY CHAU THI (AUD)
Entity type:Individual
Prefix:MRS
First Name:MY CHAU
Middle Name:THI
Last Name:STYN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:MY CHAU
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3900 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4551
Mailing Address - Country:US
Mailing Address - Phone:215-823-4074
Mailing Address - Fax:215-823-4585
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-4074
Practice Address - Fax:215-823-4585
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006196231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist