Provider Demographics
NPI:1639670474
Name:KING, ATONA DALANNE
Entity Type:Individual
Prefix:
First Name:ATONA
Middle Name:DALANNE
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 1:18 NAGLE ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4450
Mailing Address - Country:US
Mailing Address - Phone:603-557-4990
Mailing Address - Fax:
Practice Address - Street 1:18 NAGLE ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4450
Practice Address - Country:US
Practice Address - Phone:603-557-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical