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General NPI Number Information
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NPI Number | 1861536278
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Entity Type | Individual
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Provider Name | DEBRA DENISE KING LPC
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Gender | Female
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2300 HENDERSON MILL RD NE SUITE 411
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City | ATLANTA
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State | GA
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Zip | 30345-2745
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Country | US
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Telephone | 678-643-7823
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 573
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City | ELLENWOOD
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State | GA
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Zip | 30294-0573
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Country | US
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Telephone | 678-643-7823
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002738
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License Number State | GA
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