Doctor Name: | MS. SANDRA H QUINN |
NPI Number: | 1124250212 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 202 |
Business Practice Address: | 49 Welles St Suite 216 Glastonbury, CT - 060334205 |
Business Phone Number: | 8603677708 |
Business Fax Number: | 8602632065 |
Mailing Address: | 49 Welles St Ste 216, GLASTONBURY |
State: | CT |
Postal Code: | 060334205 |
Phone Number: | 8603677708 |
Fax Number: | 8602632065 |
NPI Enumeration Date: | 08/22/2009 |
NPI Last Update Date: | 01/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |