Provider Demographics
NPI:1710181730
Name:QUICK, MAE IRIS (BS)
Entity Type:Individual
Prefix:
First Name:MAE
Middle Name:IRIS
Last Name:QUICK
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CHURCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4807
Mailing Address - Country:US
Mailing Address - Phone:336-882-6572
Mailing Address - Fax:
Practice Address - Street 1:311 CHURCH AVENUE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4807
Practice Address - Country:US
Practice Address - Phone:336-882-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health