Provider Demographics
NPI:1518156637
Name:CHUN, JINSOO (MS)
Entity Type:Individual
Prefix:MS
First Name:JINSOO
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 HIDDEN VALLEY CLUB DR
Mailing Address - Street 2:APT. #318
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-8022
Mailing Address - Country:US
Mailing Address - Phone:734-709-6602
Mailing Address - Fax:
Practice Address - Street 1:610 HIDDEN VALLEY CLUB DR
Practice Address - Street 2:APT. #318
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-8022
Practice Address - Country:US
Practice Address - Phone:734-709-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist