Individual
MS. INDIA CHEATHAM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 514-2529
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY202839
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548536634
—
ID
Enumeration date
03/22/2012
Last updated
11/13/2018
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