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General NPI Number Information
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NPI Number | 1962980292
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Entity Type | Individual
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Provider Name | KENYA LATONYA KING PHD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 14502 N DALE MABRY HIGHWAY
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City | TAMPA
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State | FL
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Zip | 33618-2705
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Country | US
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Telephone | 813-402-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 14210 CYBER PL APT 301
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City | TAMPA
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State | FL
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Zip | 33613-6169
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Country | US
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Telephone | 917-930-0096
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY10101
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License Number State | FL
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