Provider Demographics
NPI:1073051876
Name:QUARLES-BRINSON, QUANDA
Entity Type:Individual
Prefix:
First Name:QUANDA
Middle Name:
Last Name:QUARLES-BRINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5667
Mailing Address - Country:US
Mailing Address - Phone:702-384-2238
Mailing Address - Fax:
Practice Address - Street 1:2725 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5667
Practice Address - Country:US
Practice Address - Phone:702-384-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst