Provider Demographics
NPI:1225869423
Name:JEONG, YOUNG-HIE GLENDA
Entity type:Individual
Prefix:
First Name:YOUNG-HIE
Middle Name:GLENDA
Last Name:JEONG
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 1:1744 PREAKNESS AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-2269
Mailing Address - Country:US
Mailing Address - Phone:702-918-3418
Mailing Address - Fax:
Practice Address - Street 1:350 REVERE ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-1633
Practice Address - Country:US
Practice Address - Phone:915-691-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker