Individual
AMY RUTH KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
7438 BLAISDELL AVE, RICHFIELD, MN 55423-4136
(763) 250-8385
Mailing address
7438 BLAISDELL AVE, RICHFIELD, MN 55423-4136
(763) 250-8385
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1145
MN
251S00000X
Community/Behavioral Health Agency
Primary
1145
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/24/2012
Last updated
02/20/2021
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