Provider Information for 1972253797
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DASOMI JANG LCSW
Sex: Female
NPI: 1972253797
Last Updated: 2022-03-27
Certification Date: 2022-03-27
Certification Date: 2022-03-27
Details
| Name | Value | ||||||||||||||
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| NPI | 1972253797 | ||||||||||||||
| Enumeration Date | 2022-03-25 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 11434 RAPALLO LN WINDERMERE, FL 34786-6029 United States Phone: 407-218-9759 | Fax: | ||||||||||||||
| Primary Practice Address | 4001 PELEE ST ORLANDO, FL 32817-3100 United States Phone: 407-718-1581 | Fax: | ||||||||||||||
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