Provider Demographics
NPI:1689729360
Name:QUINN, JANICE LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNN
Last Name:QUINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 ALLUMBAUGH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9208
Mailing Address - Country:US
Mailing Address - Phone:208-376-3546
Mailing Address - Fax:208-376-9792
Practice Address - Street 1:315 ALLUMBAUGH ST
Practice Address - Street 2:BOISE PSYCHOLOGICAL SERVICES
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9208
Practice Address - Country:US
Practice Address - Phone:208-376-3546
Practice Address - Fax:208-376-9792
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-277891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical