Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6654 | MA |
Y | 103TC0700X | Clinical Psychologist | 6654 | MA |
NPI | 1013155183 |
---|---|
Provider Name | Dr. Sunglim A. Shin |
First Address | Cambridge, MA 02138-5004 |
Second Address | Cambridge, MA 02138-5004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2009 |
Last Update Date | 28/01/2009 |