Provider Information for 1174114821
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Miss YAEEUN JI LMHC
Sex: Female
NPI: 1174114821
Last Updated: 2023-01-04
Certification Date: 2023-01-04
Certification Date: 2023-01-04
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174114821 | ||||||||
| Enumeration Date | 2021-01-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 290 LENOX AVE FL 3 NEW YORK, NY 10027-4991 United States Phone: 917-566-3799 | Fax: | ||||||||
| Primary Practice Address | 290 LENOX AVE FL 3 NEW YORK, NY 10027-4991 United States Phone: 917-566-3799 | Fax: | ||||||||
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