Individual
KYALA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
731 POLO RD, COLUMBIA, SC 29223-4462
(803) 788-8655
Mailing address
731 POLO RD, COLUMBIA, SC 29223-4462
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3490
SC
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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