Provider Information for 1437938636
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
JOOKYOUNG JACKIE FAANA LCSW
Sex: Female
NPI: 1437938636
Last Updated: 2023-09-26
Certification Date: 2023-09-26
Certification Date: 2023-09-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1437938636 | ||||||||
| Enumeration Date | 2023-09-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 392 CANYON STONE CIR LAKE MARY, FL 32746-3936 United States Phone: 808-779-7706 | Fax: | ||||||||
| Primary Practice Address | 392 CANYON STONE CIR LAKE MARY, FL 32746-3936 United States Phone: 808-779-7706 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|