Provider Demographics
NPI:1235582669
Name:KING, MESCHELLE
Entity Type:Individual
Prefix:
First Name:MESCHELLE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 WEBB BRIDGE RD
Mailing Address - Street 2:2382
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4256
Mailing Address - Country:US
Mailing Address - Phone:678-561-4408
Mailing Address - Fax:
Practice Address - Street 1:4575 WEBB BRIDGE RD
Practice Address - Street 2:2382
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4256
Practice Address - Country:US
Practice Address - Phone:678-561-4408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health