Provider Demographics
NPI:1689966855
Name:KING, KRISTEN ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ANNE
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26170
Mailing Address - Street 2:1100 WEST MARKET STREET, 3RD FLOOR
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-6170
Mailing Address - Country:US
Mailing Address - Phone:336-346-3192
Mailing Address - Fax:336-346-3197
Practice Address - Street 1:1100 W MARKET ST FL 3
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1830
Practice Address - Country:US
Practice Address - Phone:336-346-3192
Practice Address - Fax:336-346-3197
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4108103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical