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General NPI Number Information
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NPI Number | 1114747326
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Entity Type | Organization
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Legal Business Name | KIM THERAPY GROUP PLLC
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 7950 NW 53RD ST STE 337
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City | MIAMI
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State | FL
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Zip | 33166-4791
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Country | US
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Telephone | 786-763-0006
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660065
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City | MIAMI SPRINGS
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State | FL
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Zip | 33266-0065
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Country | US
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Telephone | 786-763-0006
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CHARLES KIM
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Credential | LMHC
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Telephone | 786-763-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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