Individual
CHELSEA QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2686 SPRING ST, REDWOOD CITY, CA 94063
(650) 368-3345
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
372600000X
Adult Companion
—
OR
Other
Enumeration date
08/15/2017
Last updated
06/04/2018
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