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NPI Code Detail

MEDICARE: QUEEN-JENEVE SZYMONIAK BT

MEDICARE: QUEEN-JENEVE SZYMONIAK BT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianTX
2101YM0800XMental Health CounselorLH70014989WA

General Provider Information

NPI Number : 1861035370
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUEEN-JENEVE SZYMONIAK BT
Provider Business Mailing Address
First Line : 9800 4TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-2152
Country : US
Telephone Number : 206-302-1200
Fax Number : 877-516-8135
Provider Business Practice Location Address
First Line : 6025 SPORTS VILLAGE RD
Second Line :
City : FRISCO
State : TX
Zip : 75033-3505
Country : US
Telephone Number : 214-687-9374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2019
Last Update Date : 06/05/2026

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