Individual
JADE QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCMA, CPT
Contact information
Practice address
2760 W PEORIA AVE # 1277, PHOENIX, AZ 85029-5202
(626) 339-4999
Mailing address
2760 W PEORIA AVE # 1277, PHOENIX, AZ 85029-5202
(626) 339-4999
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AZ
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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