Provider Demographics
NPI:1386462489
Name:KIM, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
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 1:4700 W 27TH ST APT II6
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-4207
Mailing Address - Country:US
Mailing Address - Phone:785-592-0003
Mailing Address - Fax:
Practice Address - Street 1:4700 W 27TH ST APT II6
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-4207
Practice Address - Country:US
Practice Address - Phone:785-592-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician