Provider Demographics
NPI:1730755299
Name:HIDAY, KIM
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HIDAY
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 1:6845 ELM ST STE 440
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-6028
Mailing Address - Country:US
Mailing Address - Phone:703-734-0211
Mailing Address - Fax:703-734-0201
Practice Address - Street 1:6845 ELM ST STE 440
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-6028
Practice Address - Country:US
Practice Address - Phone:703-734-0211
Practice Address - Fax:703-734-0201
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist