MEDICARE: SHARLA KAY KING

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1790479178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLA KAY KING

Provider Business Mailing Address
First Line	:	135 COUNTRY CLUB DR
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-2024
Country	:	US
Telephone Number	:	940-456-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 COUNTRY CLUB DR
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-2024
Country	:	US
Telephone Number	:	940-456-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	06/07/2023

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Directions to “ SHARLA KAY KING ” Practice Location

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