| NPI | 1639265085 |
|---|---|
| Former Name | DERONDA VYNETTE KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2018-09-19 |