Individual
CLYDE SHELLY KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2633 S BEULAH ST, PHILADELPHIA, PA 19148-4514
(215) 501-2612
Mailing address
2633 S BEULAH ST, PHILADELPHIA, PA 19148-4514
(215) 501-2612
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC014966
PA
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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