Doctor Name: | JENNIFER B KING |
NPI Number: | 1902273410 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED, LPC, CSC |
License Number: | 394268 |
Business Practice Address: | 3581 Ga Highway 300 Oakfield, GA - 317721826 |
Business Phone Number: | 2298692963 |
Business Fax Number: | |
Mailing Address: | 3581 Ga Highway 300, OAKFIELD |
State: | GA |
Postal Code: | 317721826 |
Phone Number: | 2298692963 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2015 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | 394268 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |