Individual
KYLE JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2021047112
MO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/19/2018
Last updated
01/14/2022
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