Provider Demographics
NPI:1477678225
Name:QUINTANA, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:FACTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3470 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-1520
Mailing Address - Country:US
Mailing Address - Phone:719-545-1181
Mailing Address - Fax:719-546-6667
Practice Address - Street 1:3470 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1520
Practice Address - Country:US
Practice Address - Phone:719-545-1181
Practice Address - Fax:719-546-6667
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health