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General NPI Number Information
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NPI Number | 1295677086
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Entity Type | Individual
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Provider Name | JACQUELYN MARIE KING B.S, SLP-ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 603 EDBURTON CT
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-9704
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Country | US
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Telephone | 919-240-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 4809 SINGING WOODS PL
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City | DURHAM
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State | NC
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Zip | 27712-2832
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Country | US
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Telephone | 984-227-2306
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Fax |
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 0645
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License Number State | NC
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