Individual
ELAINE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
335 RANDON TER, LAKE MARY, FL 32746-2624
(407) 988-6500
Mailing address
335 RANDON TER, LAKE MARY, FL 32746-2624
(407) 988-6500
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-25-16591
FL
106S00000X
Behavior Technician
RBT-22-225665
FL
106S00000X
Behavior Technician
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Other
Enumeration date
07/26/2022
Last updated
11/11/2025
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