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General NPI Number Information
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NPI Number | 1598954588
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Entity Type | Individual
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Provider Name | ZHUJUN JIANG PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3816 27TH ST
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City | MOLINE
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State | IL
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Zip | 61265-6343
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Country | US
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Telephone | 309-944-7833
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Fax | 309-403-0554
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Provider Business Mailing Address
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Address Line | 3816 27TH ST
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City | MOLINE
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State | IL
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Zip | 61265-6343
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Country | US
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Telephone | 309-944-7833
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Fax | 309-403-0554
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071009562
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License Number State | IL
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