Individual
KERRI LYNN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1094
KS
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS01230
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS
PROFESSIONAL LICENSE
RI
Enumeration date
05/24/2007
Last updated
09/19/2011
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