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Individual

JUN YI GINNY CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3073 PANTHERSVILLE RD, DECATUR, GA 30034-3828
(404) 243-2136
Mailing address
PMB 220 1579 MONROE DR NE SUITE F, ATLANTA, GA 30324

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004130
GA
103TF0200X
Forensic Psychologist
PSY004130
GA

Other

Enumeration date
04/26/2023
Last updated
04/26/2023
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