Individual
MRS. TARA MICHELLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19213 E 5TH STREET CT N, INDEPENDENCE, MO 64056-2211
(816) 489-6332
Mailing address
19213 E 5TH STREET CT N, INDEPENDENCE, MO 64056-2211
(816) 489-6332
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1999141155
MO
Other
Enumeration date
05/01/2013
Last updated
05/02/2013
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