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General NPI Number Information
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NPI Number | 1437494655
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Entity Type | Organization
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Legal Business Name | DR. YONG H. KIM, PSYD, PROFESSIONAL LIMITED COMPANY
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 8101 NW 10TH
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City | OKLAHOMA CITY
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State | OK
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Zip | 73127
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Country | US
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Telephone | 405-365-7556
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Fax |
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Provider Business Mailing Address
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Address Line | 13004 WILLOWCREST LN.
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170
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Country | US
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Telephone | 405-365-7556
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. YONG H. KIM
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Credential | PSY.D.
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Telephone | 405-365-7556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1109
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License Number State | OK
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