Provider Demographics
NPI:1720966450
Name:ADUSEI-POKU, QUINTON DARREN
Entity type:Individual
Prefix:
First Name:QUINTON
Middle Name:DARREN
Last Name:ADUSEI-POKU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8919 SKYROCK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1417
Mailing Address - Country:US
Mailing Address - Phone:202-802-6650
Mailing Address - Fax:
Practice Address - Street 1:7175 COLUMBIA GATEWAY DR STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2536
Practice Address - Country:US
Practice Address - Phone:888-344-5977
Practice Address - Fax:888-439-3040
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1-07-3757106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty