Healthcare Provider Details

I. General information

NPI: 1083335756
Provider Name (Legal Business Name): JOHN T JUNKER PSY.D., M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMRTC NAPLES OSPEDALE MARINA USA VIA CONTRADA BOSCARIELLO
GRICIGNANO DI AVERSA CE
81030
IT

IV. Provider business mailing address

PSC 808 BOX 2616
FPO AE
09618-0027
US

V. Phone/Fax

Practice location:
  • Phone: 314-629-6306
  • Fax:
Mailing address:
  • Phone: 314-629-6309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810008589
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: