Doctor Name: | COLLEEN QUAILE |
NPI Number: | 1366511636 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 5223 |
Business Practice Address: | 90 Route 44 Raynham, MA - 027671433 |
Business Phone Number: | 5088806868 |
Business Fax Number: | 5088806848 |
Mailing Address: | 90 Route 44, RAYNHAM |
State: | MA |
Postal Code: | 027671433 |
Phone Number: | 5088806868 |
Fax Number: | 5088806848 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |