| NPI | 1104161116 |
|---|---|
| Former Name | MARCIA KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3007793) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007793) |
| Enumeration Date | 2012-12-02 |
| Last Update Date | 2022-09-08 |