# MRS. MISTY LEIGH WHITE- KING

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1851460778
- **Gender:** F
- **Credential:** OCCUPATIONAL THERAPY

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 056005570 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 056005570 | IL | — |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 07/24/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8432032 | BCBS PROVIDER NUMBER | IL |