Individual
BRENDA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDCIII
Contact information
Practice address
151 E MAIN ST, JACKSON, OH 45640-1742
(740) 286-1888
Mailing address
9645 BEAVER PIKE, JACKSON, OH 45640-9310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
141047
OH
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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