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NPI Code Detail

MEDICARE: ALFONZA A. KING LPC

MEDICARE:   ALFONZA A. KING  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPC009399GA

General Provider Information

NPI Number : 1386155430
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFONZA A. KING LPC
Provider Business Mailing Address
First Line : 3846 TRASK DR
Second Line :
City : COLUMBUS
State : GA
Zip : 31903-2937
Country : US
Telephone Number : 706-566-3166
Fax Number :
Provider Business Practice Location Address
First Line : 3846 TRASK DR
Second Line :
City : COLUMBUS
State : GA
Zip : 31903-2937
Country : US
Telephone Number : 706-566-3166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2017
Last Update Date : 10/17/2017

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Directions to “ ALFONZA A. KING LPC” Practice Location

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