Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3345 | TN |
Y | 103TC0700X | Clinical Psychologist | 3345 | TN |
N | 103G00000X | Clinical Psychologist | 54960 | MS |
N | 103TC0700X | Clinical Psychologist | 54960 | MS |
N | 103G00000X | Clinical Psychologist | PSY9194 | FL |
N | 103TC0700X | Clinical Psychologist | PSY9194 | FL |
NPI | 1003230350 |
---|---|
Provider Name | Dr. Kyong Han |
First Address | Collierville, TN 38017-1266 |
Second Address | Memphis, TN 38119-4806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2014 |
Last Update Date | 15/10/2018 |