Provider Demographics
NPI:1144399130
Name:QUINTAL, LAURIE (LICSW)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:QUINTAL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 JOHN ROLFE DR
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3846
Mailing Address - Country:US
Mailing Address - Phone:508-999-7753
Mailing Address - Fax:
Practice Address - Street 1:6 PLYMPTON ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1602
Practice Address - Country:US
Practice Address - Phone:508-947-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2108511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical