Provider Demographics
NPI:1629690623
Name:QUEEN, KENDRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:
Last Name:QUEEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 BAYER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5784
Mailing Address - Country:US
Mailing Address - Phone:512-584-1114
Mailing Address - Fax:
Practice Address - Street 1:4904 BAYER HOLLOW DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-5784
Practice Address - Country:US
Practice Address - Phone:512-584-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health