Provider Demographics
NPI:1285920686
Name:KIM, WON MI
Entity type:Individual
Prefix:MISS
First Name:WON MI
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:APT #5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3383
Mailing Address - Country:US
Mailing Address - Phone:917-558-5042
Mailing Address - Fax:
Practice Address - Street 1:60 MADISON AVE.
Practice Address - Street 2:8TH FLOOR BILINGUALS INC.,
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8731
Practice Address - Country:US
Practice Address - Phone:212-684-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2328190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst