Provider Demographics
NPI:1366809303
Name:KING, PRECIOUS
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 CENTANNI DR
Mailing Address - Street 2:
Mailing Address - City:SAINT BERNARD
Mailing Address - State:LA
Mailing Address - Zip Code:70085-5811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8550 UNITED PLAZA BLVD STE 702
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-0200
Practice Address - Country:US
Practice Address - Phone:985-603-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist