Provider Demographics
NPI:1518557818
Name:QUIGLEY, ANN GERALYNE (LICENSED BEHAVIOR SP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:GERALYNE
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:LICENSED BEHAVIOR SP
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:GERALYN
Other - Last Name:SOWERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICENSED BEHAVIOR SP
Mailing Address - Street 1:5157 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052
Mailing Address - Country:US
Mailing Address - Phone:610-295-9333
Mailing Address - Fax:
Practice Address - Street 1:5157 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052
Practice Address - Country:US
Practice Address - Phone:610-295-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003621103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst