Provider Demographics
NPI:1043003296
Name:KING, AMELIA
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:KING
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SHATTUCK RD UNIT 2205
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-2471
Mailing Address - Country:US
Mailing Address - Phone:617-595-1116
Mailing Address - Fax:
Practice Address - Street 1:16 CLARKE ST STE 21
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4938
Practice Address - Country:US
Practice Address - Phone:978-254-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist