Individual
KELLY CARROLL MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
1320 OLD CHAIN BRIDGE RD STE 185, MC LEAN, VA 22101
(703) 942-8110
Mailing address
1320 OLD CHAIN BRIDGE RD STE 185, MC LEAN, VA 22101-3945
(703) 866-8819
(855) 750-3325
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001692
VA
231H00000X
Audiologist
AU 2286
CA
237600000X
Audiologist-Hearing Aid Fitter
2101002412
VA
Other
Enumeration date
02/09/2007
Last updated
12/19/2019
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