Individual
KATLYNN QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5177 MAPLE ST, CLARKSBURG, WV 26301-6932
(304) 266-4493
Mailing address
5177 MAPLE ST, CLARKSBURG, WV 26301-6932
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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