Individual
LAKIA SHANNON KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 SHORTHILLS LANE, UNIT103, MELBOURNE, FL 32905-3290
(860) 573-5303
Mailing address
635 SHORT HILLS LN UNIT 103, MELBOURNE, FL 32905-2272
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/27/2019
Last updated
06/30/2022
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