MEDICARE: VERONICA ANN JUNG M.S.W.

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
1	104100000X	Social Worker	VJ088769	MI

General Provider Information

NPI Number	:	1497982607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA ANN JUNG M.S.W.

Provider Business Mailing Address
First Line	:	PO BOX 427
Second Line	:
City	:	HILLMAN
State	:	MI
Zip	:	49746-0427
Country	:	US
Telephone Number	:	989-742-4583
Fax Number	:	989-742-2183

Provider Business Practice Location Address
First Line	:	610 CARING ST
Second Line	:
City	:	HILLMAN
State	:	MI
Zip	:	49746-8818
Country	:	US
Telephone Number	:	989-742-4583
Fax Number	:	989-742-2183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2009
Last Update Date	:	02/23/2010

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