Doctor Name: | DIANNA SUE QUICK |
NPI Number: | 1053706994 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | E2351 |
Business Practice Address: | 3017 Emerson Ave Parkersburg, WV - 261042415 |
Business Phone Number: | 3048655444 |
Business Fax Number: | 3048655445 |
Mailing Address: | 3017 Emerson Ave, PARKERSBURG |
State: | WV |
Postal Code: | 261042415 |
Phone Number: | 3048655444 |
Fax Number: | 3048655445 |
NPI Enumeration Date: | 03/30/2015 |
NPI Last Update Date: | 03/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | E2351 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |