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General NPI Number Information
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NPI Number | 1457848186
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Entity Type | Individual
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Provider Name | ONI KING
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 1056 N OTTOKEE ST
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City | WAUSEON
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State | OH
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Zip | 43567-1900
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Country | US
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Telephone | 419-404-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 FORAKER AVE
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City | TOLEDO
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State | OH
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Zip | 43609-3122
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 166438
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License Number State | OH
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