Provider Demographics
NPI:1013314657
Name:KIM, BINNA (AUD)
Entity type:Individual
Prefix:DR
First Name:BINNA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16405 PASADENA CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2114
Mailing Address - Country:US
Mailing Address - Phone:201-658-6042
Mailing Address - Fax:
Practice Address - Street 1:16405 PASADENA CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2114
Practice Address - Country:US
Practice Address - Phone:201-658-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1055231H00000X
NE456231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist