Individual
DR. SUZZANNE CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
10591 165TH ST W, LAKEVILLE, MN 55044-3528
(952) 898-1133
(952) 435-6797
Mailing address
10591 165TH ST W, LAKEVILLE, MN 55044-3528
(952) 898-1133
(952) 435-6797
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4658
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
955796200
—
MN
Enumeration date
10/18/2006
Last updated
09/15/2009
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