Individual
SUSAN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CNSC
Contact information
Practice address
21011 STORRS RD, SACKETS HARBOR, NY 13685-3172
(720) 771-6691
(720) 771-6691
Mailing address
21011 STORRS ROAD, SACKETS HARBOR, NY 13685
(720) 771-6691
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1105343
CO
Other
Enumeration date
09/08/2014
Last updated
07/21/2022
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