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NPI Code Detail

MEDICARE: ALLISON NICOLE MCQUEEN LISW MSW

MEDICARE: ALLISON NICOLE MCQUEEN LISW MSW
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
1104100000XSocial Worker
21041C0700XClinical Social WorkerI.2203939OH

General Provider Information

NPI Number : 1932620036
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON NICOLE MCQUEEN LISW MSW
Provider Business Mailing Address
First Line : 885 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5267
Country : US
Telephone Number : 419-575-8952
Fax Number :
Provider Business Practice Location Address
First Line : 885 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5267
Country : US
Telephone Number : 419-575-8952
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2017
Last Update Date : 11/17/2022

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