Provider Demographics
NPI:1154547917
Name:KING, TIMOTHY L (PHD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:L
Last Name:KING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 TAYLORSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1316
Mailing Address - Country:US
Mailing Address - Phone:215-493-7380
Mailing Address - Fax:215-493-7382
Practice Address - Street 1:1078 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1316
Practice Address - Country:US
Practice Address - Phone:215-493-7380
Practice Address - Fax:215-493-7382
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003437L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical