Provider Demographics
NPI:1255750253
Name:JUNGE, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:JUNGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8358 CRYSTAL HARBOUR DR
Mailing Address - Street 2:APT 202
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8358 CRYSTAL HARBOUR DR
Practice Address - Street 2:APT 202
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3086
Practice Address - Country:US
Practice Address - Phone:224-766-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health