Provider Demographics
NPI:1134719107
Name:KING, KRYSTLE DAWNE (MS, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:DAWNE
Last Name:KING
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9545 KATY FWY STE 425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1471
Mailing Address - Country:US
Mailing Address - Phone:713-628-3966
Mailing Address - Fax:
Practice Address - Street 1:9545 KATY FWY STE 425
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1471
Practice Address - Country:US
Practice Address - Phone:713-628-3966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health