Individual
JEANNE PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 CONTROLS DR, SUITE 10, SHELTON, CT 06484-6157
(203) 525-8280
(866) 394-4521
Mailing address
30 CONTROLS DR, SUITE 10, SHELTON, CT 06484-6157
(203) 525-8280
(866) 394-4521
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004025219
—
CT
Enumeration date
06/25/2012
Last updated
12/29/2016
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