Provider Demographics
NPI:1780832683
Name:MCQUEEN, TASHIKA L (MSCE)
Entity Type:Individual
Prefix:MRS
First Name:TASHIKA
Middle Name:L
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:MSCE
Other - Prefix:MS
Other - First Name:TASHIKA
Other - Middle Name:L
Other - Last Name:SPANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCE
Mailing Address - Street 1:1032 STATE HWY 50 W
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773
Mailing Address - Country:US
Mailing Address - Phone:662-524-4347
Mailing Address - Fax:662-524-4364
Practice Address - Street 1:217 COURT ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-2926
Practice Address - Country:US
Practice Address - Phone:662-494-7060
Practice Address - Fax:662-494-7533
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health