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General NPI Number Information
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NPI Number | 1649863762
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Entity Type | Organization
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Legal Business Name | AUDREY ALBERT KING BODY-CENTERED PSYCHOTHERAPY
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 7 MYSTIC ST STE 200
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City | ARLINGTON
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State | MA
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Zip | 02474-1136
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Country | US
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Telephone | 508-954-6838
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Fax | 617-870-4880
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Provider Business Mailing Address
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Address Line | 3022 SYMMES CIR
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City | ARLINGTON
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State | MA
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Zip | 02474-2978
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Country | US
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Telephone | 508-954-6838
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Fax | 617-870-4880
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | AUDREY ALBERT KING
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Credential | LMHC, BC-DMT, MA
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Telephone | 508-954-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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