Doctor Name: | MRS. KIJUNG BAE KANG |
NPI Number: | 1376614552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | |
Business Practice Address: | 1620 Elton Rd Suite 204 Silver Spring, MD - 209031740 |
Business Phone Number: | 3014397191 |
Business Fax Number: | |
Mailing Address: | 6520 Midra Dr, LANHAM |
State: | MD |
Postal Code: | 207063560 |
Phone Number: | 2404638965 |
Fax Number: | |
NPI Enumeration Date: | 11/10/2006 |
NPI Last Update Date: | 08/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |