Provider Demographics
NPI:1649817412
Name:JEUNE, DAPHNEY
Entity type:Individual
Prefix:
First Name:DAPHNEY
Middle Name:
Last Name:JEUNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4287 REFLECTIONS BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8250
Mailing Address - Country:US
Mailing Address - Phone:754-302-9366
Mailing Address - Fax:
Practice Address - Street 1:4287 REFLECTIONS BLVD APT 202
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8250
Practice Address - Country:US
Practice Address - Phone:754-302-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician