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NPI 1982842621

NPI 1982842621 : KALI MCQUEEN PC : NILES, OH

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General NPI Number Information
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    NPI Number           |    1982842621
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    Entity Type          |    Individual 
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    Provider Name        |    KALI MCQUEEN PC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/03/2009
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    Last Update Date     |    07/18/2024
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Provider Practice Location Address
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    Address Line         |    165 E PARK AVE 
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    City                 |    NILES
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    State                |    OH
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    Zip                  |    44446-2352
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    Country              |    US
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    Telephone            |    330-544-8005
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    Fax                  |    330-544-9379
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Provider Business Mailing Address
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    Address Line         |    465 ALAMEDA AVE 
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    City                 |    YOUNGSTOWN
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    State                |    OH
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    Zip                  |    44504-1455
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    Country              |    US
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    Telephone            |    215-317-1654
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    PC003610
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    C.2204119
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    License Number State |    OH
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