Individual
JEAN JUNGMI YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12746 CIMARRON PATH STE 103C, SAN ANTONIO, TX 78249-3420
(718) 316-5358
Mailing address
18726 S WESTERN AVE STE 408, GARDENA, CA 90248-3858
(310) 856-0800
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59366
TX
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-20-111754
TX
Other
Enumeration date
06/10/2020
Last updated
05/04/2022
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