Doctor Name: | MS. TAYA KING |
NPI Number: | 1043512379 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | LPCC 0118911 |
Business Practice Address: | 3147 Chestnut Ln Evergreen, CO - 804398653 |
Business Phone Number: | 3036740271 |
Business Fax Number: | |
Mailing Address: | 3147 Chestnut Ln, EVERGREEN |
State: | CO |
Postal Code: | 804398653 |
Phone Number: | 3039276101 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2010 |
NPI Last Update Date: | 11/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPCC 0118911 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |