Provider Demographics
NPI:1598282469
Name:KIM, MINSU (PHD)
Entity Type:Individual
Prefix:DR
First Name:MINSU
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:16, JUKBAEK 4-RO
Mailing Address - Street 2:SOSABEUL THE SHARP MASTERVIEW, 101-DONG 2504-HO
Mailing Address - City:PYEONGTAEK-SI
Mailing Address - State:GYEONGGI-DO
Mailing Address - Zip Code:17863
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SHINJANG-DONG 325-70
Practice Address - Street 2:MIRAE TOWER, 2ND FLOOR, INTEGRATED COUNSELING SERVICES
Practice Address - City:PYEONGTAEK
Practice Address - State:GYEONGGI-DO
Practice Address - Zip Code:17758
Practice Address - Country:KR
Practice Address - Phone:031-662-7571
Practice Address - Fax:031-662-7572
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2023-08-04
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Provider Licenses
StateLicense IDTaxonomies
MD06726103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist