Individual
KATLIN QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 HOLLY LN, CHAGRIN FALLS, OH 44022-4198
(216) 202-0785
Mailing address
150 HOLLY LN, CHAGRIN FALLS, OH 44022-4198
(216) 202-0785
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
02/28/2021
Last updated
02/01/2022
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