Individual
DEANNA E MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 TOWNE PARK DR, RINCON, GA 31326-5156
(912) 556-0101
Mailing address
800 TOWNE PARK DR, RINCON, GA 31326-5156
(912) 556-0101
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
10/29/2021
Last updated
10/29/2021
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