Provider Demographics
NPI:1497962245
Name:QUINN, CHRISTOPHER K (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:K
Last Name:QUINN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E. WILSON ST.
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703
Mailing Address - Country:US
Mailing Address - Phone:608-251-4466
Mailing Address - Fax:
Practice Address - Street 1:312 E WILSON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3427
Practice Address - Country:US
Practice Address - Phone:608-251-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI769-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist