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NPI Code Detail

MEDICARE: MS. VALERIE EUNSEOUNG KANG

MEDICARE: MS. VALERIE EUNSEOUNG KANG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist2500631NY
2103K00000XBehavior Analyst002681-01NY
3103K00000XBehavior Analyst1-22-61264GA

General Provider Information

NPI Number : 1467709816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VALERIE EUNSEOUNG KANG
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 2083 NEWNAN CROSSING BLVD E
Second Line :
City : NEWNAN
State : GA
Zip : 30265-2606
Country : US
Telephone Number : 470-241-1408
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2012
Last Update Date : 09/08/2023

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Directions to “ MS. VALERIE EUNSEOUNG KANG ” Practice Location

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