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General NPI Number Information
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NPI Number | 1821975962
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Entity Type | Individual
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Provider Name | KRISTIE D KIM
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Gender | Female
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 850 HUNGERFORD DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-1718
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Country | US
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Telephone | 240-740-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 10113 WALKER LAKE DR
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City | GREAT FALLS
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State | VA
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Zip | 22066-3501
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Country | US
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Telephone | 301-908-9765
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | MD
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