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General NPI Number Information
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NPI Number | 1538677091
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Entity Type | Individual
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Provider Name | SARA L JUNG CT
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Gender | Female
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 484 OLD STATE ROUTE 74 # 55
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City | CINCINNATI
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State | OH
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Zip | 45244-4239
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Country | US
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Telephone | 513-752-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 5684 BISCAYNE AVE
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City | CINCINNATI
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State | OH
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Zip | 45248-4256
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Country | US
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Telephone | 513-375-9297
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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