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NPI Code Detail

MEDICARE: YELINA KIM CCC-SLP

MEDICARE:   YELINA  KIM  CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSL012198PA

General Provider Information

NPI Number : 1003213653
Entity Type Code : Individual
Provider Name (Legal Business Name) : YELINA KIM CCC-SLP
Provider Business Mailing Address
First Line : 234 SAINT MARYS ST
Second Line :
City : PHOENIXVILLE
State : PA
Zip : 19460-3235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 234 SAINT MARYS ST
Second Line :
City : PHOENIXVILLE
State : PA
Zip : 19460-3235
Country : US
Telephone Number : 724-674-5038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2014
Last Update Date : 11/25/2014

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Directions to “ YELINA KIM CCC-SLP” Practice Location

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