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Individual
KING OTHA
Active
Individual
KING OTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
91961
CA
104100000X
Social Worker
ACSW91961
CA
1041C0700X
Clinical Social Worker
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/12/2020
Last updated
10/09/2023
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