Individual
TIAUNA QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHSIII
Contact information
Practice address
3214 PROSPECT AVE E, CLEVELAND, OH 44115-2614
(216) 910-9015
Mailing address
3214 PROSPECT AVE E, CLEVELAND, OH 44115-2614
(216) 910-9015
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.003028
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
QMHSIII
OH
Enumeration date
06/23/2021
Last updated
04/09/2025
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