Provider Demographics
NPI: | 1588798607 |
---|---|
Name: | AHN, JEE-YOUNG |
Entity Type: | Individual |
Prefix: | DR |
First Name: | JEE-YOUNG |
Middle Name: | |
Last Name: | AHN |
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: | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | TACOMA |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98431-0001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 253-968-2252 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10 N JEFFERSON ST STE 403 |
Practice Address - Street 2: | |
Practice Address - City: | FREDERICK |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21701-4823 |
Practice Address - Country: | US |
Practice Address - Phone: | 301-620-8700 |
Practice Address - Fax: | 301-320-8710 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-03-14 |
Last Update Date: | 2021-02-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | 4941 | 103K00000X, 103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TH0004X, 103TM1800X, 103TP0814X, 103TP2701X, 103TS0200X, 106H00000X, 103T00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family |
No | 103TH0004X | Behavioral Health & Social Service Providers | Psychologist | Health |
No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities |
No | 103TP0814X | Behavioral Health & Social Service Providers | Psychologist | Psychoanalysis |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |