Provider Demographics
NPI:1952460701
Name:KAUFMAN, JUNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:
Last Name:KAUFMAN
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:PO BOX 1264
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-1264
Mailing Address - Country:US
Mailing Address - Phone:404-321-6206
Mailing Address - Fax:404-321-7788
Practice Address - Street 1:315 W PONCE DE LEON AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2400
Practice Address - Country:US
Practice Address - Phone:404-321-6206
Practice Address - Fax:404-321-7788
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000936103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical