Provider Demographics
NPI:1063574846
Name:MICHELE KING, PH.D., P.C.
Entity type:Organization
Organization Name:MICHELE KING, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:334-821-1822
Mailing Address - Street 1:703 EAST GLENN AVENUE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5016
Mailing Address - Country:US
Mailing Address - Phone:334-821-1822
Mailing Address - Fax:334-821-1822
Practice Address - Street 1:703 E GLENN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5016
Practice Address - Country:US
Practice Address - Phone:334-821-1822
Practice Address - Fax:334-821-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051515491Other051515491
AL051099555Other051099555
AL051099555Other051099555
ALR63070Medicare UPIN