Provider Demographics
NPI:1568615276
Name:QUINLAN, JOANNA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 FOGGINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-3608
Mailing Address - Country:US
Mailing Address - Phone:845-279-6242
Mailing Address - Fax:845-279-6242
Practice Address - Street 1:303 FOGGINTOWN RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-3608
Practice Address - Country:US
Practice Address - Phone:854-279-6242
Practice Address - Fax:845-279-6242
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014863-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist