Provider Demographics
NPI:1760508014
Name:KING, H ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:ELIZABETH
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:HARRIETTE
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18 LENOX POINTE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324
Mailing Address - Country:US
Mailing Address - Phone:404-352-4348
Mailing Address - Fax:404-352-4334
Practice Address - Street 1:18 LENOX POINTE NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324
Practice Address - Country:US
Practice Address - Phone:404-352-4348
Practice Address - Fax:404-352-4334
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000356103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical