Provider Demographics
NPI:1225465859
Name:KIM, SOOK HEE (MA)
Entity Type:Individual
Prefix:MS
First Name:SOOK
Middle Name:HEE
Last Name:KIM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 EASTON RD APT 9A6
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038
Mailing Address - Country:US
Mailing Address - Phone:267-632-9548
Mailing Address - Fax:
Practice Address - Street 1:805 EASTON RD APT 9A6
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-5237
Practice Address - Country:US
Practice Address - Phone:267-632-9548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst