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Individual

DR. MIKE KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
2900 LOUISIANA BOULEVARD NORTHEAST, SUITE C1, ALBUQUERQUE, NM 87110
(505) 884-7873
Mailing address
2900 LOUISIANA BOULEVARD NORTHEAST, SUITE C1, ALBUQUERQUE, NM 87110
(505) 884-7873

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY21256
CA
103TP0016X
Prescribing (Medical) Psychologist
Primary
0036
NM

Other

Enumeration date
11/16/2012
Last updated
09/14/2016
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