MEDICARE: HYEJIN KIM M.ED., BCBA

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1982451308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYEJIN KIM M.ED., BCBA

Provider Business Mailing Address
First Line	:	20328 LONGENBAUGH RD
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-8685
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20328 LONGENBAUGH RD
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-8685
Country	:	US
Telephone Number	:	832-230-1939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	04/06/2026

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