Provider Demographics
NPI:1972092773
Name:KING, ANABELLEE KANG
Entity type:Individual
Prefix:
First Name:ANABELLEE
Middle Name:KANG
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 MAIN ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3186
Mailing Address - Country:US
Mailing Address - Phone:410-686-3629
Mailing Address - Fax:443-968-8136
Practice Address - Street 1:493 MAIN ST UNIT 101
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3186
Practice Address - Country:US
Practice Address - Phone:410-686-3629
Practice Address - Fax:443-968-8136
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM997106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist