Individual
ANITRA S KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3230 CORK BEND DR, INDIANAPOLIS, IN 46239-7668
(317) 540-3457
Mailing address
3230 CORK BEND DR, INDIANAPOLIS, IN 46239-7668
(317) 540-3457
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
IN
3747P1801X
Personal Care Attendant
Primary
24-017479-1
IN
Other
Enumeration date
05/28/2021
Last updated
08/25/2024
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