Individual
JUSTIN T. KOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2437 MINERAL SPRINGS RD, SUITE C, LEXINGTON, SC 29072-9145
(803) 520-8295
(803) 520-8298
Mailing address
2437 MINERAL SPRINGS RD, SUITE C, LEXINGTON, SC 29072-9145
(803) 520-8295
(803) 520-8298
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
5343
SC
106H00000X
Marriage & Family Therapist
IMT1490
FL
Other
Enumeration date
07/22/2011
Last updated
02/15/2012
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