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General NPI Number Information
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NPI Number | 1619054996
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Entity Type | Individual
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Provider Name | ROBERT PAUL KING PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 10045 W LISBON AVE 221
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City | WAUWATOSA
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State | WI
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Zip | 53222-2446
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Country | US
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Telephone | 414-358-7144
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Fax | 414-358-7158
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Provider Business Mailing Address
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Address Line | 8500 N INDIAN CREEK PKWY
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City | FOX POINT
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State | WI
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Zip | 53217-2345
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Country | US
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Telephone | 414-351-1959
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1207-057
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License Number State | WI
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