Doctor Name: | MRS. JUDY KING |
NPI Number: | 1114386497 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2013038290 |
Business Practice Address: | 202 Nw Str Str 1 Ava, MO - 65608 |
Business Phone Number: | 4175435737 |
Business Fax Number: | |
Mailing Address: | Rr 7 Box 7465, AVA |
State: | MO |
Postal Code: | 656089787 |
Phone Number: | 4175435737 |
Fax Number: | |
NPI Enumeration Date: | 02/16/2016 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2013038290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |