King, Desiree Lorraine

King, Desiree Lorraine is an sole proprietor health care provider with primary practice located at 1821 Business Park Blvd , Daytona Beach FL 32114-1230. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. King, Desiree Lorraine can be contacted via phone (386) 366-6700.

Contact Information

Primary practice address
1821 Business Park Blvd Daytona Beach FL 32114-1230
Phone: (386) 366-6700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY9986 Florida

Profile Details

NPI number 1215289970
LBN Legal business name King, Desiree Lorraine
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2012
Last updated Oct 25th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215289970 NPPES
Massachusetts MEDICAID 1300881

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