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1144564303
LA DETRIA KING
AUGUSTA, GA
NPI
1144564303
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: GA LPC006088)
Enumeration Date
2012-11-11
Last Update Date
2012-11-11
Business Address
-- LA DETRIA KING LPC
2610 COMMONS BLVD SUITE B
AUGUSTA, GA 30909-2080
Phone number: 706-832-6679
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Mailing Address
-- LA DETRIA KING LPC
2918 HENRY ST
AUGUSTA, GA 30909-3848
Phone number: 706-832-6679
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