Doctor Name: | ANNIE GAY KING |
NPI Number: | 1386813988 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | 4337 |
Business Practice Address: | 210 S Mayes St Pryor, OK - 743613228 |
Business Phone Number: | 9189319292 |
Business Fax Number: | |
Mailing Address: | 210 S Mayes St, PRYOR |
State: | OK |
Postal Code: | 743613228 |
Phone Number: | 9189319292 |
Fax Number: | |
NPI Enumeration Date: | 02/27/2008 |
NPI Last Update Date: | 02/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4337 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |