Individual
MI JOUNG LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 GLEN HOLLOW DR APT B35, HOLTSVILLE, NY 11742-2448
(631) 880-8182
Mailing address
7 GLEN HOLLOW DR APT B35, HOLTSVILLE, NY 11742-2448
(631) 880-8182
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
413187
NY
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
493929-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
637770470
—
NY
Enumeration date
09/19/2022
Last updated
09/19/2022
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