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General NPI Number Information
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NPI Number | 1043747975
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Entity Type | Individual
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Provider Name | NATASHA R KING LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 4770 AMOCO DR
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City | MOSS POINT
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State | MS
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Zip | 39563-9627
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Country | US
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Telephone | 228-474-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 2714 BRIARWOOD CIR
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City | MOSS POINT
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State | MS
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Zip | 39563-2310
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Country | US
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Telephone | 228-342-7447
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Fax | 228-475-2809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C8418
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License Number State | MS
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