Provider Demographics
NPI:1083352413
Name:KING, CAROLINE REGAN (NONE)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:REGAN
Last Name:KING
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 MARRIOTT DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-5020
Mailing Address - Country:US
Mailing Address - Phone:615-258-8400
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:555 MARRIOTT DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-5020
Practice Address - Country:US
Practice Address - Phone:615-258-8400
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician