Provider Demographics
NPI:1528545993
Name:KING, TIOYA CHARLENE
Entity Type:Individual
Prefix:
First Name:TIOYA
Middle Name:CHARLENE
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 1:4215 1ST ST SE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2876
Mailing Address - Country:US
Mailing Address - Phone:202-826-2243
Mailing Address - Fax:
Practice Address - Street 1:1200 MISSISSIPPI AVE SE APT 115
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4442
Practice Address - Country:US
Practice Address - Phone:202-826-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant