Individual
JENNIFER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, CADCII
Contact information
Practice address
149 S MAIN ST, PHOENIX, OR 97535-6631
(541) 535-4133
(541) 535-5458
Mailing address
149 S MAIN ST, PHOENIX, OR 97535-6631
(541) 535-4133
(541) 535-5458
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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