Doctor Name: | MS. TONJA JEAN JUNGWIRTH |
NPI Number: | 1154669125 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., LPC-MH |
License Number: | LPC-MH2230 |
Business Practice Address: | 115 W 7th St Redfield, SD - 574691034 |
Business Phone Number: | 6054601616 |
Business Fax Number: | |
Mailing Address: | 115 W 7th St, REDFIELD |
State: | SD |
Postal Code: | 574691034 |
Phone Number: | 6054601616 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2013 |
NPI Last Update Date: | 01/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-MH2230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |