Individual
MICHELLE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 SOUTH ST STE 403, PHILADELPHIA, PA 19146-1514
(215) 990-4390
Mailing address
5031 CEDAR AVE, PHILADELPHIA, PA 19143-1620
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC013839
PA
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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