Individual
TRINITY QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
RBT
Contact information
Practice address
120 BROADUS AVE STE 100, GREENVILLE, SC 29601-3040
(803) 335-0718
Mailing address
16255 VENTURA BLVD STE 900, ENCINO, CA 91436-2317
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-533213
—
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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