Provider Demographics
NPI:1326194184
Name:QUINN, KRISTEN CONOVER (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:CONOVER
Last Name:QUINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N. MEDICAL DR.
Mailing Address - Street 2:DEPT OF SOCIAL WORK
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132
Mailing Address - Country:US
Mailing Address - Phone:801-585-2847
Mailing Address - Fax:801-585-2818
Practice Address - Street 1:50 N. MEDICAL DR.
Practice Address - Street 2:DEPT OF SOCIAL WORK
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132
Practice Address - Country:US
Practice Address - Phone:801-585-2847
Practice Address - Fax:801-585-2818
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47396546004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional