Individual
STACIA ROSE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 828-0871
Mailing address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 828-0871
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
222776
MA
Other
Enumeration date
06/11/2018
Last updated
08/18/2020
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