Provider Demographics
NPI:1255670881
Name:MARTEL, QUINCY
Entity Type:Individual
Prefix:
First Name:QUINCY
Middle Name:
Last Name:MARTEL
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:PO BOX 1469
Mailing Address - Street 2:MYRTLE PARK PROFESSION CENTER STE 303
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910
Mailing Address - Country:US
Mailing Address - Phone:843-255-6020
Mailing Address - Fax:
Practice Address - Street 1:1905 DUKE ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4403
Practice Address - Country:US
Practice Address - Phone:843-255-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional