Provider Demographics
NPI:1437844164
Name:YUNKER, JUSTINE DANIELLE
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:DANIELLE
Last Name:YUNKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GLEDHILL DR
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-2306
Mailing Address - Country:US
Mailing Address - Phone:567-338-2068
Mailing Address - Fax:
Practice Address - Street 1:5 GLEDHILL DR
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2306
Practice Address - Country:US
Practice Address - Phone:567-338-2068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health