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General NPI Number Information
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NPI Number | 1528883634
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Entity Type | Individual
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Provider Name | DR. NAYOUNG KIM
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 19528 OLNEY MILL RD
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City | OLNEY
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State | MD
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Zip | 20832-1111
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Country | US
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Telephone | 240-740-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 6049 SHEPHERD SQ
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City | COLUMBIA
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State | MD
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Zip | 21044-3133
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5666
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | CER-117845-X3F2W6
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License Number State | MD
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