Individual
JENNIFER EILEEN QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. BCBA
Contact information
Practice address
8017 N SUNDANCE DR, COEUR D ALENE, ID 83815-7028
(208) 659-5517
Mailing address
8017 N SUNDANCE DR, COEUR D ALENE, ID 83815-7028
(208) 659-5517
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-9676
—
Other
Enumeration date
02/08/2013
Last updated
10/15/2015
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