Provider Demographics
NPI:1629294350
Name:CHUNG, HYUNJOO (PHD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:HYUNJOO
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:
Other - First Name:HYUNJOO
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD CCC-SLP
Mailing Address - Street 1:1700 W FRANKFORD RD
Mailing Address - Street 2:#1209
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1790 KING ARTHUR BLVD STE 130
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-2041
Practice Address - Country:US
Practice Address - Phone:469-998-1291
Practice Address - Fax:855-933-2591
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP14261235Z00000X
TX109694235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty