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NPI Code Detail

MEDICARE: DR. AJA DIONNA KING ED.D.

MEDICARE:  DR. AJA DIONNA KING  ED.D.
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
1103TC1900XCounseling Psychologist
2101YM0800XMental Health Counselor944MN

General Provider Information

NPI Number : 1821423740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AJA DIONNA KING ED.D.
Provider Business Mailing Address
First Line : 6312 WELCOME AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55429-2047
Country : US
Telephone Number : 205-451-7955
Fax Number :
Provider Business Practice Location Address
First Line : 6312 WELCOME AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55429-2047
Country : US
Telephone Number : 205-451-7955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2013
Last Update Date : 02/13/2024

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