Provider Demographics
NPI:1356217988
Name:KIM, NAYOUNG (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:NAYOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CF-SLP
Mailing Address - Street 1:7329 BOULDER VIEW LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4953
Mailing Address - Country:US
Mailing Address - Phone:804-562-7307
Mailing Address - Fax:
Practice Address - Street 1:7329 BOULDER VIEW LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-4953
Practice Address - Country:US
Practice Address - Phone:804-562-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty