| Organization Name: | GARY L. JUNE, PSYD, LLC |
| NPI Number: | 1275807752 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY L JUNE (OWNER) |
| Mailing Address: | 125 W State Highway 174 Republic |
| State: | MO US |
| Postal Code: | 657381036 |
| Phone Number: | 4172344608 |
| Fax Number: | |
| NPI Enumeration Date: | 03/01/2012 |
| NPI Last Update Date: | 03/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2003030081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |