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General NPI Number Information
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NPI Number | 1992866818
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Entity Type | Individual
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Provider Name | ROBIN LISA KING MSW,LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3939 ROSWELL RD SUITE 185
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City | MARIETTA
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State | GA
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Zip | 30062-6251
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Country | US
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Telephone | 770-641-9603
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Fax |
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Provider Business Mailing Address
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Address Line | 4640 CLARY LAKES DR NE
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City | ROSWELL
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State | GA
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Zip | 30075-5447
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Country | US
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Telephone | 770-641-7635
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW001219
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License Number State | GA
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