Individual
DR. DESIREE LORRAINE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1821 BUSINESS PARK BLVD, DAYTONA BEACH, FL 32114-1230
(386) 366-6700
Mailing address
16 CREEK BLUFF WAY, ORMOND BEACH, FL 32174
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9986
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300881
—
MA
Enumeration date
10/04/2012
Last updated
10/25/2017
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