Basic Information
| Provider Information | |||||||||
| NPI: | 1316398696 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KING | ||||||||
| FirstName: | AARON | ||||||||
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| Credential: | MA LMFT-IT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 HOOVER RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544815678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7155443345 | ||||||||
| FaxNumber: | 7159524995 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 HOOVER RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544815678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7155443345 | ||||||||
| FaxNumber: | 7159524995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2016 | ||||||||
| LastUpdateDate: | 06/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 544-228 | WI | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.