Individual
GAVIN QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4745 N CASTLE HILLS AVE, BOISE, ID 83703-2765
(208) 626-4805
Mailing address
3415 BATAAN MEMORIAL W, LAS CRUCES, NM 88012-5012
(505) 392-3482
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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