| Doctor Name: | MINKYUNG SO |
| NPI Number: | 1003223033 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 80802 |
| Business Practice Address: | 3530 Atlantic Ave Ste. 210 Long Beach, CA - 908074569 |
| Business Phone Number: | 5624241886 |
| Business Fax Number: | 5624242296 |
| Mailing Address: | 1942 Rodney Dr, #17 LOS ANGELES |
| State: | CA |
| Postal Code: | 900273158 |
| Phone Number: | 7143214250 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2014 |
| NPI Last Update Date: | 07/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 80802 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |