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Individual

KACEY REIKO CHRISTINA KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
65 PRIVATE DRIVE 1130, ESPANOLA, NM 87532-3530
(808) 557-4300
Mailing address
65 PRIVATE DRIVE 1130, ESPANOLA, NM 87532-3530
(808) 557-4300

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
09/15/2016
Last updated
09/21/2025
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Product
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