Provider Demographics
NPI:1659723799
Name:QUINTANA, SARAH (MA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 E FLORENCE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4228
Mailing Address - Country:US
Mailing Address - Phone:520-705-7847
Mailing Address - Fax:
Practice Address - Street 1:1115 E FLORENCE BLVD STE A
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4228
Practice Address - Country:US
Practice Address - Phone:520-705-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor