Provider Demographics
NPI:1811220965
Name:KING, DORIS A (PRESCHOOL TEACHER)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:PRESCHOOL TEACHER
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:A
Other - Last Name:ZACARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 28220
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87592-8220
Mailing Address - Country:US
Mailing Address - Phone:505-471-5006
Mailing Address - Fax:505-820-9220
Practice Address - Street 1:1110 E HIGH ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2510
Practice Address - Country:US
Practice Address - Phone:575-461-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor