| Kaitlin King, Llc. | |
|
408 E. Dodds Bloomington IN 47401-4819 | |
| (812) 287-3616 | |
| Not Available |
| Full Name | Kaitlin King, Llc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 408 E. Dodds, Bloomington, Indiana |
| Authorized Official Name and Position | Kiana-marie Vaughn (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8123453055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaitlin King, Llc. 408 E. Dodds Bloomington IN 47401-4819 Ph: (812) 287-3616 | Kaitlin King, Llc. 408 E. Dodds Bloomington IN 47401-4819 Ph: (812) 287-3616 |
| NPI Number | 1942852488 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 07/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942852488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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