Individual
MS. THEODORA MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
470 SILVERWOOD AVE APT D, UPLAND, CA 91786-5111
(951) 800-3738
Mailing address
2100 SHILOH VALLEY DR NW, #1137, KENNESAW, GA 30144-4514
(404) 993-9493
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
03/24/2015
Last updated
03/09/2017
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