Provider Demographics
NPI:1740399609
Name:KING, MONICA LORRAINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:LORRAINE
Last Name:KING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 ALOMA AVE
Mailing Address - Street 2:SUITE 136
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2541
Mailing Address - Country:US
Mailing Address - Phone:407-539-1935
Mailing Address - Fax:888-545-2346
Practice Address - Street 1:2431 ALOMA AVE
Practice Address - Street 2:SUITE 136
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-539-1935
Practice Address - Fax:888-545-2346
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical