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General NPI Number Information
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NPI Number | 1144757402
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Entity Type | Organization
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Legal Business Name | DR JAMIE KING THE CTR FOR PSYCHOLOGICAL SVC & LIFE COACH, LLC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 05/14/2023
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Provider Practice Location Address
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Address Line | 1275 S MAIN ST STE 101
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City | GREENSBURG
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State | PA
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Zip | 15601-5385
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Country | US
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Telephone | 724-221-6394
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 S MAIN ST STE 101
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City | GREENSBURG
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State | PA
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Zip | 15601-5385
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Country | US
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Telephone | 724-221-6394
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Fax | 724-420-5593
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Authorized Official
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Title or Position | MEMBER/PSYCHOLOGIST
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Name | DR. JAMIE MICHELLE KING
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Credential | PHD
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Telephone | 724-221-6394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017392
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License Number State | PA
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