Provider Demographics
NPI:1609197508
Name:QUINN, MAUREEN PATRICIA (LSLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:QUINN
Suffix:
Gender:F
Credentials:LSLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SQUIRE DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3443
Mailing Address - Country:US
Mailing Address - Phone:716-508-8144
Mailing Address - Fax:
Practice Address - Street 1:130 SQUIRE DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-3443
Practice Address - Country:US
Practice Address - Phone:716-508-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004816-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist