Provider Demographics
NPI:1730470261
Name:KING, LOIS MARIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6649
Mailing Address - Country:US
Mailing Address - Phone:509-599-7316
Mailing Address - Fax:
Practice Address - Street 1:1119 W JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6649
Practice Address - Country:US
Practice Address - Phone:509-599-7316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000063131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical