Individual
KEISHA QUEENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
945 E INDIANOLA AVE, YOUNGSTOWN, OH 44502-2639
(234) 338-8038
Mailing address
945 E INDIANOLA AVE, YOUNGSTOWN, OH 44502-2639
(234) 338-8038
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508461609
DODD
OH
05
—
2910854
—
OH
Enumeration date
12/04/2020
Last updated
06/08/2025
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