Individual
JASPER QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
107 SUMMER LN, WEST MONROE, LA 71291-3501
(318) 396-1969
Mailing address
107 SUMMER LN, WEST MONROE, LA 71291-3501
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
344249
LA
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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