Doctor Name: | JEANNIE S. KIM |
NPI Number: | 1205004702 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 0130691 |
Business Practice Address: | 316 Franklin Ct Edgewater, NJ - 070201603 |
Business Phone Number: | 6467344461 |
Business Fax Number: | |
Mailing Address: | 316 Franklin Ct, EDGEWATER |
State: | NJ |
Postal Code: | 070201603 |
Phone Number: | 6467344461 |
Fax Number: | |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0130691 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |