Individual
DR. SUSAN R. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3501 HEALTH CENTER BLVD, ESTERO, FL 34135-8127
(239) 468-0300
(239) 343-4257
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6050
(239) 343-6051
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6846
FL
103TC0700X
Clinical Psychologist
PY6846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102285100
—
FL
Enumeration date
10/27/2006
Last updated
10/26/2022
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