Individual
ELAINE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 SENECA PL, DIAMOND BAR, CA 91765-4369
(909) 569-3682
Mailing address
1115 SENECA PL, DIAMOND BAR, CA 91765-4369
(909) 569-3682
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 24297
CA
Other
Enumeration date
06/29/2016
Last updated
12/03/2021
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