Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1003120973 |
---|---|
Provider Name | Dr. Yong H Kim |
First Address | Oklahoma City, OK 73170-1144 |
Second Address | Yukon, OK 73099-6754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 04/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200304690A | (05) | OK |