Individual
JUNG HWA KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6820 PARKDALE PL STE 115, INDIANAPOLIS, IN 46254-4699
(317) 329-7300
(317) 329-7325
Mailing address
6820 PARKDALE PL STE 115, INDIANAPOLIS, IN 46254-4699
(317) 329-7300
(317) 329-7325
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
20043841A
IN
103TC0700X
Clinical Psychologist
20043841A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104430576
ANTHEM PTAN
IN
05
—
300097867
—
IN
Enumeration date
07/24/2024
Last updated
12/09/2024
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