Provider Demographics
NPI:1316398696
Name:KING, AARON (MA LMFT-IT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:MA LMFT-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 HOOVER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-5678
Mailing Address - Country:US
Mailing Address - Phone:715-544-3345
Mailing Address - Fax:715-952-4995
Practice Address - Street 1:2900 HOOVER RD
Practice Address - Street 2:SUITE B
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-5678
Practice Address - Country:US
Practice Address - Phone:715-544-3345
Practice Address - Fax:715-952-4995
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI544-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist