Provider Demographics
NPI:1629411681
Name:AH QUIN, DOROTHY (MAED, CMHC)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:
Last Name:AH QUIN
Suffix:
Gender:F
Credentials:MAED, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W 630 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6131
Mailing Address - Country:US
Mailing Address - Phone:801-319-6392
Mailing Address - Fax:
Practice Address - Street 1:511 W 630 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6131
Practice Address - Country:US
Practice Address - Phone:801-319-6392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5026084-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional