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General NPI Number Information
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NPI Number | 1437882115
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Entity Type | Individual
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Provider Name | JULIE ESTHER KANG LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 3011 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8301
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Country | US
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Telephone | 541-789-0583
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Fax |
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Provider Business Mailing Address
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Address Line | 3419 CALLE VISTA DR
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City | MEDFORD
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State | OR
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Zip | 97504-9242
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Country | US
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Telephone | 541-601-8580
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4269
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License Number State | OR
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