Individual
OCTAVIA L KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7232 PROCLAMATION DR, RUTHER GLEN, VA 22546-2456
(443) 248-1463
Mailing address
7232 PROCLAMATION DR, RUTHER GLEN, VA 22546-2456
(443) 248-1463
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0903003725
VA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/09/2021
Last updated
04/17/2024
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