Provider Demographics
NPI:1689063885
Name:QUINN, CELESTE (MA)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:QUINN
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 1:6090 BEVERLY HILLS RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-1825
Mailing Address - Country:US
Mailing Address - Phone:267-377-9176
Mailing Address - Fax:
Practice Address - Street 1:826 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1174
Practice Address - Country:US
Practice Address - Phone:267-377-9176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)