Provider Demographics
NPI:1053731968
Name:YOON, SOO
Entity type:Individual
Prefix:
First Name:SOO
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:SOO-MIN
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1485 W WARM SPRINGS RD
Mailing Address - Street 2:#107
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7631
Mailing Address - Country:US
Mailing Address - Phone:702-547-0201
Mailing Address - Fax:702-944-7846
Practice Address - Street 1:1485 W WARM SPRINGS RD
Practice Address - Street 2:#107
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7631
Practice Address - Country:US
Practice Address - Phone:702-547-0201
Practice Address - Fax:702-944-7846
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor