Provider Demographics
NPI:1952509499
Name:KING, COURTNEY DEES (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:DEES
Last Name:KING
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SHADOW WOOD PARK
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3451
Mailing Address - Country:US
Mailing Address - Phone:205-733-0976
Mailing Address - Fax:205-733-0977
Practice Address - Street 1:300 SHADOW WOOD PARK
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-3451
Practice Address - Country:US
Practice Address - Phone:205-733-0976
Practice Address - Fax:205-733-0977
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-04-1480101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor