Provider Demographics
NPI:1235353947
Name:CHOI, CHUN CHUNG (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHUN CHUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 NW 37TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-0856
Mailing Address - Country:US
Mailing Address - Phone:352-222-9354
Mailing Address - Fax:
Practice Address - Street 1:301 PEABODY HALL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-4100
Practice Address - Country:US
Practice Address - Phone:352-222-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7443103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling