Provider Demographics
NPI:1275956815
Name:QUINN, KRYSTAL ELAINE
Entity Type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:ELAINE
Last Name:QUINN
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 1:12261 CRAB APPLE LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0134
Mailing Address - Country:US
Mailing Address - Phone:214-356-7635
Mailing Address - Fax:
Practice Address - Street 1:1506 N GREENVILLE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8622
Practice Address - Country:US
Practice Address - Phone:214-356-7635
Practice Address - Fax:214-509-6887
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional