Provider Demographics
NPI:1184202228
Name:KING, SHEQUITIA
Entity Type:Individual
Prefix:MRS
First Name:SHEQUITIA
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 1:860 ATLANTIC AVE APT D
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-3708
Mailing Address - Country:US
Mailing Address - Phone:773-815-5316
Mailing Address - Fax:
Practice Address - Street 1:860 ATLANTIC AVE APT D
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-3708
Practice Address - Country:US
Practice Address - Phone:773-815-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician