Individual
AMANDA WHEATLEY MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25660
MD
225200000X
Physical Therapy Assistant
AT 8377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25660
PT LICENSE
MD
Enumeration date
05/07/2007
Last updated
01/09/2025
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