Doctor Name: | MS. SAMANTHA KING |
NPI Number: | 1033504626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC |
License Number: | 8344 |
Business Practice Address: | 128 S Arcadian Way Mooresville, NC - 281179220 |
Business Phone Number: | 7044775212 |
Business Fax Number: | |
Mailing Address: | 128 S Arcadian Way, MOORESVILLE |
State: | NC |
Postal Code: | 281179220 |
Phone Number: | 7044775212 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2015 |
NPI Last Update Date: | 06/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 8344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |