Provider Demographics
NPI:1770733677
Name:JUNG, YOON KYUNG (PHD)
Entity type:Individual
Prefix:MS
First Name:YOON
Middle Name:KYUNG
Last Name:JUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:EUNIE
Other - Middle Name:
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3316 MELODY AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3114
Mailing Address - Country:US
Mailing Address - Phone:310-770-0444
Mailing Address - Fax:
Practice Address - Street 1:3635 MANASSAS DR # A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4031
Practice Address - Country:US
Practice Address - Phone:540-774-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist