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General NPI Number Information
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NPI Number | 1326025131
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Entity Type | Individual
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Provider Name | TERESA DENISE KING PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | CSOSA / RE-ENTRY & SANCTIONS CENTER 1900 MASSACHUSETTS AVENUE, BLDG. 17
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City | WASHINGTON DC
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State | DC
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Zip | 20003
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Country | US
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Telephone | 202-345-6949
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Fax |
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Provider Business Mailing Address
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Address Line | 6107 HELLEN LEE DR
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City | CLINTON
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State | MD
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Zip | 20735-3430
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Country | US
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Telephone | 202-534-2966
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2026
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License Number State | AL
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