Individual
MRS. KATHY ANN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
Mailing address
PO BOX 285, 1903 PORTLAND RD, JOPPA, IL 62953-0285
(618) 638-4001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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