Provider Demographics
NPI:1497982607
Name:JUNG, VERONICA ANN (MSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ANN
Last Name:JUNG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-0427
Mailing Address - Country:US
Mailing Address - Phone:989-742-4583
Mailing Address - Fax:989-742-2183
Practice Address - Street 1:610 CARING ST
Practice Address - Street 2:
Practice Address - City:HILLMAN
Practice Address - State:MI
Practice Address - Zip Code:49746-8818
Practice Address - Country:US
Practice Address - Phone:989-742-4583
Practice Address - Fax:989-742-2183
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIVJ088769104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicare PIN