Individual
MR. ANTONIO KING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSATP
Contact information
Practice address
519 XENIA AVE, DAYTON, OH 45410-1823
(937) 589-2277
Mailing address
303 MEADOWLAKE RD, YORKTOWN, VA 23693-3617
(757) 713-0385
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103027
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000615
VA
Other
Enumeration date
01/25/2020
Last updated
09/11/2023
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