Provider Demographics
NPI:1194566109
Name:WILSON-KING, TOCCARA NICOLE
Entity type:Individual
Prefix:
First Name:TOCCARA
Middle Name:NICOLE
Last Name:WILSON-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 1:1305 CUMBERLAND AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1343
Mailing Address - Country:US
Mailing Address - Phone:574-360-9011
Mailing Address - Fax:
Practice Address - Street 1:1305 CUMBERLAND AVE STE 225
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1343
Practice Address - Country:US
Practice Address - Phone:574-360-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator