Provider Demographics
NPI:1609684562
Name:KING, ASHLEY MARIKA MONEEK
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIKA MONEEK
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5930
Mailing Address - Country:US
Mailing Address - Phone:910-605-8032
Mailing Address - Fax:
Practice Address - Street 1:198 HEARTWOOD DR
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-5930
Practice Address - Country:US
Practice Address - Phone:910-605-8032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-24
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-25-409721106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician