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General NPI Number Information
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NPI Number | 1649734054
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Entity Type | Individual
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Provider Name | MRS. NACKYANA CHRISTINE KING
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Gender | Female
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 212 STATE ROAD 436 # 212
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City | CASSELBERRY
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State | FL
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Zip | 32707-4943
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Country | US
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Telephone | 689-255-1075
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5366
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City | WINTER PARK
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State | FL
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Zip | 32793-5366
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Country | US
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Telephone | 954-668-9535
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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