Provider Demographics
NPI:1851818553
Name:QUANBECK, JOANNA E (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:E
Last Name:QUANBECK
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:JO
Other - Middle Name:E
Other - Last Name:QUANBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:241 S CLEVELAND AVE
Mailing Address - Street 2:SUITE B4
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105
Mailing Address - Country:US
Mailing Address - Phone:651-243-1727
Mailing Address - Fax:
Practice Address - Street 1:241 S CLEVELAND AVE
Practice Address - Street 2:SUITE B4
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105
Practice Address - Country:US
Practice Address - Phone:651-243-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6454103T00000X, 103TC1900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty