Individual
KENDRA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW, EIS
Contact information
Practice address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
(940) 766-4942
Mailing address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
(940) 766-4942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T22Y
BCBS #
TX
05
—
111408401
—
TX
05
—
111408402
—
TX
Enumeration date
08/31/2006
Last updated
08/08/2011
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