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General NPI Number Information
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NPI Number | 1093335077
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Entity Type | Individual
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Provider Name | MARCIA LAWRENCE KING BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 5000 OAKTON ST APT 308
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City | SKOKIE
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State | IL
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Zip | 60077-2979
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Country | US
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Telephone | 847-975-0433
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Fax |
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Provider Business Mailing Address
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Address Line | 6033 N SHERIDAN RD APT 19M
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City | CHICAGO
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State | IL
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Zip | 60660-3026
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Country | US
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Telephone | 847-975-0433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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