Provider Demographics
NPI:1740429638
Name:QUINN, DORELLA LEIGH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DORELLA
Middle Name:LEIGH
Last Name:QUINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DORE
Other - Middle Name:LEIGH
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, LPC
Mailing Address - Street 1:2651 SAGEBRUSH DR STE 108
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2727
Mailing Address - Country:US
Mailing Address - Phone:945-201-0634
Mailing Address - Fax:
Practice Address - Street 1:2651 SAGEBRUSH DR STE 108
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2727
Practice Address - Country:US
Practice Address - Phone:945-201-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64725101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health