Shaquana Cue

Individual provider Active NPI Developmental Therapist · Roswell, GA

NPI 1922473602 · NPPES record last updated Dec 7, 2015

Key facts

NPI
1922473602
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
300 Colonial Center Pkwy
Ste 100N
Roswell, GA 30076-4899
Phone
(954) 603-7885
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

300 Colonial Center Pkwy
Ste 100N
Roswell, GA 30076-4899

Mailing address

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817

Other identifiers

IdentifierTypeStateIssuer
ZCS0819950OtherSCBLUE CROSS BLUE SHIELD

Other providers in Roswell, GA

All providers in Roswell, GA · Developmental Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.