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General NPI Number Information
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NPI Number | 1548933864
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Entity Type | Individual
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Provider Name | MEREDITH LEE KING
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Gender | Female
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Dates
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Enumeration Date | 08/01/2021
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Last Update Date | 08/01/2021
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Provider Practice Location Address
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Address Line | 705 E MAIN ST
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City | WYTHEVILLE
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State | VA
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Zip | 24382-3301
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Country | US
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Telephone | 276-223-0672
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Fax |
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Provider Business Mailing Address
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Address Line | 1 NEW RIVER DR APT 1100H
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City | RADFORD
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State | VA
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Zip | 24141-1892
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Country | US
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Telephone | 304-921-6518
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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 | VA
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