Provider Demographics
NPI:1811563455
Name:YOON, JI-YOUNG (PHD)
Entity Type:Individual
Prefix:DR
First Name:JI-YOUNG
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 GAITHER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4016
Mailing Address - Country:US
Mailing Address - Phone:301-424-5200
Mailing Address - Fax:
Practice Address - Street 1:2092 GAITHER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4016
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:301-424-8063
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 221700000X
CT3383103T00000X
CA33593103T00000X
MD06984103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist