Individual
ALECA QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
414 S PINE ST, WALHALLA, SC 29691-2146
(864) 886-4400
Mailing address
414 S PINE ST, WALHALLA, SC 29691-2146
(864) 886-4400
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
10154
SC
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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