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Individual

MS. KIM MARIE PAULINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
8 S MAPLE AVE, SUITE A, PARK RIDGE, NJ 07656-2137
(315) 383-7862
(866) 475-1097
Mailing address
8 S MAPLE AVE, SUITE A, PARK RIDGE, NJ 07656-2137
(315) 383-7862
(866) 475-1097

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
133N00000X
Nutritionist
Primary
133NN1002X
Nutrition Education Nutritionist

Other

Enumeration date
11/20/2014
Last updated
11/03/2016
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