Provider Demographics
NPI:1598300998
Name:KIM, DOROTHY (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:DOROTHY
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SADORE LN APT 3C
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4748
Mailing Address - Country:US
Mailing Address - Phone:646-678-1103
Mailing Address - Fax:
Practice Address - Street 1:1326 E 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5754
Practice Address - Country:US
Practice Address - Phone:718-787-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst