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General NPI Number Information
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NPI Number | 1487719548
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Entity Type | Individual
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Provider Name | ANDREA A KING LPC
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 225 CREEKSTONE RDG STE 2
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City | WOODSTOCK
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State | GA
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Zip | 30188-3744
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Country | US
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Telephone | 470-546-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 3595 CANTON RD STE# 312 PMB217
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City | MARIETTA
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State | GA
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Zip | 30066-2693
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Country | US
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Telephone | 470-546-8346
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC003236
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License Number State | GA
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