Provider Demographics
NPI:1861680191
Name:QUINTERO, JOANN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:S
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:SPADAFORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1422 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6825
Mailing Address - Country:US
Mailing Address - Phone:615-202-0623
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-798-5931
Practice Address - Fax:270-798-6037
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2809103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling