Provider Demographics
NPI:1023843646
Name:ABOYAH, QUEEN LIZA AYINESOM (MSW)
Entity type:Individual
Prefix:
First Name:QUEEN LIZA
Middle Name:AYINESOM
Last Name:ABOYAH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SCHROEDER CT STE 210
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2503
Mailing Address - Country:US
Mailing Address - Phone:608-268-6530
Mailing Address - Fax:
Practice Address - Street 1:26 SCHROEDER CT STE 210
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2503
Practice Address - Country:US
Practice Address - Phone:608-268-6530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135495-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker