Individual
DR. ALAN RUSSELL KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2100 S. COLUMBIA ROAD, SUITE 202, GRAND FORKS, ND 58201-5895
(701) 772-1588
(701) 746-6077
Mailing address
714 N 25TH ST, GRAND FORKS, ND 58203-2945
(701) 795-9113
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
184
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16995
—
ND
Enumeration date
07/18/2006
Last updated
07/08/2007
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