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General NPI Number Information
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NPI Number | 1619019825
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Entity Type | Organization
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Legal Business Name | SALLY KING, PH.D., P.A.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1898 CALHOUN ST UNIT # 5
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City | COLUMBIA
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State | SC
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Zip | 29201-2612
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Country | US
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Telephone | 803-252-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1898 CALHOUN ST UNIT # 5
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City | COLUMBIA
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State | SC
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Zip | 29201-2612
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Country | US
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Telephone | 803-252-5300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SALLY KING
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Credential | PH.D.
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Telephone | 803-252-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | SC 217
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License Number State | SC
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