Individual provider · Type 1 NPI

Trystan Robert Queen, CMS

Addiction (Substance Use Disorder) Counselor · Bainbridge, OH

NPI number 1639665656 Active

Practice location

1071 Tong Hollow Rd
Bainbridge, OH 45612-1500

Mailing address

178 Mill Run Rd Lot 107
Waverly, OH 45690-8809

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1639665656

Trystan Robert Queen, CMS's National Provider Identifier is 1639665656, issued on Jul 2, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Bainbridge, OH. The record was last updated on Mar 2, 2023.