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Individual

MRS. OLIVIA W KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, ACSW

Contact information

Practice address
3701 BELLEMEADE AVE, EVANSVILLE, IN 47714-0137
(812) 479-1411
(812) 437-2636
Mailing address
3701 BELLEMEADE AVE, EVANSVILLE, IN 47714-0137
(812) 479-1411
(812) 437-2636

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1212
KY
1041C0700X
Clinical Social Worker
Primary
34003438A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000379073
ANTHEM BC AND BS
IN
Enumeration date
12/15/2006
Last updated
09/17/2008
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