Doctor Name: | MRS. KERI COTHERN KING |
NPI Number: | 1033265566 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 7209 |
Business Practice Address: | 619 Willis Ave Bogalusa, LA - 704273001 |
Business Phone Number: | 9857326610 |
Business Fax Number: | 9857326626 |
Mailing Address: | 1500 Sunset Dr, BOGALUSA |
State: | LA |
Postal Code: | 704278700 |
Phone Number: | 9857324742 |
Fax Number: | |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |