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General NPI Number Information
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NPI Number | 1265579122
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Entity Type | Individual
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Provider Name | GLORIA KING LPC, MA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | PINON & COTTONWOOD DR BUILDING # 2301
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City | SHIPROCK
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State | NM
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Zip | 87420
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Country | US
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Telephone | 505-368-1438
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Fax | 505-368-1461
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Provider Business Mailing Address
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Address Line | PO BOX 1830
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City | SHIPROCK
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State | NM
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Zip | 87420-1830
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Country | US
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Telephone | 505-368-1438
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Fax | 505-368-1461
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0097601
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License Number State | NM
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