Individual
MRS. IVA L KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 BLANCHE DR, BROOKS, GA 30205-1501
(770) 719-2444
Mailing address
155 BLANCHE DR, BROOKS, GA 30205-1501
(770) 719-2444
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
000383
GA
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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