Individual
INGRID GRACE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1800 JFK BLVD., STE. 1404, PHILADELPHIA, PA 19103
(215) 399-9764
Mailing address
1000 JEFFERSON ST., STE. 2C, LYNCHBURG, VA 24504
(617) 349-0496
(617) 807-0958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC006939
PA
101YP2500X
Professional Counselor
Primary
PC006939
PA
Other
Enumeration date
08/22/2013
Last updated
03/18/2015
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