Provider Demographics
NPI:1336751197
Name:LIM, HUI-CHUNG JACQUELINA
Entity Type:Individual
Prefix:
First Name:HUI-CHUNG
Middle Name:JACQUELINA
Last Name:LIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 COUNTY ROAD D E APT 303
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5249
Mailing Address - Country:US
Mailing Address - Phone:763-318-8088
Mailing Address - Fax:
Practice Address - Street 1:1233 SHERMAN DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6133
Practice Address - Country:US
Practice Address - Phone:720-449-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst