Provider Demographics
NPI:1477685956
Name:KING, CAROL M (MED)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 ROCKWELL RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1718
Mailing Address - Country:US
Mailing Address - Phone:215-784-5954
Mailing Address - Fax:
Practice Address - Street 1:512 WEST AVE
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2725
Practice Address - Country:US
Practice Address - Phone:215-885-1835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health