Provider Demographics
NPI:1508554676
Name:ESTHER S KIM, LLC DBA BRIGHT SPEECH THERAPY
Entity Type:Organization
Organization Name:ESTHER S KIM, LLC DBA BRIGHT SPEECH THERAPY
Other - Org Name:BRIGHT SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:562-480-7111
Mailing Address - Street 1:9995 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-7805
Mailing Address - Country:US
Mailing Address - Phone:225-283-5797
Mailing Address - Fax:225-425-3468
Practice Address - Street 1:9995 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-7805
Practice Address - Country:US
Practice Address - Phone:225-283-5797
Practice Address - Fax:225-425-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1942435714Medicaid
LA1265938070Medicaid