Individual
ALICIA D KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6811 MAYFIELD RD APT 686, MAYFIELD HTS, OH 44124-2222
(520) 431-6457
Mailing address
6811 MAYFIELD RD APT 686, MAYFIELD HTS, OH 44124-2222
(520) 431-6457
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150731
OH
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34-1836284
—
OH
Enumeration date
03/12/2018
Last updated
07/18/2022
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