Provider Information for 1750446779
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MUNSU KWON LCPC
Sex: Male
NPI: 1750446779
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1750446779 | ||||||||
| Enumeration Date | 2006-12-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 11508 SUTHERLAND HILL WAY SILVER SPRING, MD 20904-4206 United States Phone: 301-625-3342 | Fax:301-625-3342 | ||||||||
| Primary Practice Address | 11508 SUTHERLAND HILL WAY SILVER SPRING, MD 20904-4206 United States Phone: 301-625-3342 | Fax:301-625-3342 | ||||||||
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