Individual
MRS. ANDREA JEAN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
775 LEXINGTON AVE, MANSFIELD, OH 44907-1906
(419) 774-4110
Mailing address
2000 NOBLE DR, WOOSTER, OH 44691-5353
(330) 264-3232
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
150041
OH
104100000X
Social Worker
Primary
S.1904156
OH
Other
Enumeration date
04/21/2017
Last updated
04/09/2021
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