Provider Demographics
NPI:1578767240
Name:QUAID, MONA
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:QUAID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:
Other - Last Name:MARTIIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 268
Mailing Address - Street 2:
Mailing Address - City:WILBURTON
Mailing Address - State:OK
Mailing Address - Zip Code:74578-9651
Mailing Address - Country:US
Mailing Address - Phone:918-465-2459
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 268
Practice Address - Street 2:
Practice Address - City:WILBURTON
Practice Address - State:OK
Practice Address - Zip Code:74578-9651
Practice Address - Country:US
Practice Address - Phone:918-465-2459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health