Individual
MICHELLE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
819 RITCHIE HWY STE 2001, SEVERNA PARK, MD 21146-4163
(667) 500-4556
Mailing address
815 RITCHIE HWY STE 112, SEVERNA PARK, MD 21146-4192
(667) 500-4556
(443) 443-0704
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LGP15628
MD
221700000X
Art Therapist
ATG203
MD
Other
Enumeration date
07/31/2023
Last updated
09/24/2024
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