Provider Demographics
NPI:1619105368
Name:JUNI, AARON N (PHD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:N
Last Name:JUNI
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 1:2501 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2505
Mailing Address - Country:US
Mailing Address - Phone:443-379-0033
Mailing Address - Fax:443-215-3502
Practice Address - Street 1:2501 SMITH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2505
Practice Address - Country:US
Practice Address - Phone:443-379-0033
Practice Address - Fax:443-215-3502
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04651103TC0700X
VA0810004116103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD025306500Medicaid
MD025306500Medicaid