Provider Demographics
NPI:1639851025
Name:KIM, GENEE CORINNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GENEE
Middle Name:CORINNE
Last Name:KIM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5633
Mailing Address - Country:US
Mailing Address - Phone:830-515-9778
Mailing Address - Fax:
Practice Address - Street 1:714 CROSS ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5633
Practice Address - Country:US
Practice Address - Phone:830-515-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist