Individual
JEONG EUN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
70 HAWTHORNE AVE, PARK RIDGE, NJ 07656-1221
(509) 590-9979
Mailing address
70 HAWTHORNE AVE, PARK RIDGE, NJ 07656-1221
(509) 590-9979
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01069500
NJ
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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