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1255925004
QUEEN IDEMUDIA
BLACKLICK, OH
NPI
1255925004
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-02-23
Last Update Date
2021-02-23
Business Address
QUEEN IDEMUDIA
1582 N WAGGONER RD
BLACKLICK, OH 43004-8669
Phone number: 303-989-8169
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Mailing Address
QUEEN IDEMUDIA
1582 N WAGGONER RD
BLACKLICK, OH 43004-8669
Phone number:
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