Individual
AUDREY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 BREA BLVD, FULLERTON, CA 92835-2787
(714) 256-1000
Mailing address
2525 BREA BLVD, FULLERTON, CA 92835-2787
(714) 256-1000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15293
CA
Other
Enumeration date
12/04/2020
Last updated
12/18/2020
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