Individual
JENNIFER KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, JD, MHA
Contact information
Practice address
593 EDDY STREET MAIN BLDG RM 038, PROVIDENCE, RI 02903
(401) 444-4779
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD18556
RI
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
05/04/2018
Last updated
09/11/2023
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