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General NPI Number Information
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NPI Number | 1588231153
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Entity Type | Individual
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Provider Name | ERICA LYNNE KING-TOLER PHD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 626 RIVERSIDE DR APT 15O
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City | NEW YORK
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State | NY
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Zip | 10031-7222
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Country | US
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Telephone | 917-796-3084
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Fax |
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Provider Business Mailing Address
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Address Line | 626 RIVERSIDE DR APT 15O
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City | NEW YORK
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State | NY
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Zip | 10031-7222
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Country | US
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Telephone | 917-796-3084
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 04656
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 017580
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License Number State | NY
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