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Individual

KAYCIE VB KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
4740 KINGSWAY DR STE 33, INDIANAPOLIS, IN 46205-1521
(317) 828-0211
(888) 887-0932
Mailing address
4740 KINGSWAY DR STE 33, INDIANAPOLIS, IN 46205-1521
(317) 828-0211

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005035A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200859350 A
LEGACY PROVIDER IDENTIFIE
IN
Enumeration date
07/31/2007
Last updated
01/20/2023
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