Individual
ANTAWAIN TAVARIO KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QBA
Contact information
Practice address
5370 E CRAIG RD, 2299, LAS VEGAS, NV 89115-2100
(702) 762-1208
Mailing address
5370 E CRAIG RD, 2299, LAS VEGAS, NV 89115-2100
(702) 762-1208
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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