Provider Demographics
NPI:1881862704
Name:QUINTANA, BELINDA M (MC)
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:M
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5022 N 54TH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-7531
Mailing Address - Country:US
Mailing Address - Phone:623-931-4343
Mailing Address - Fax:623-939-3476
Practice Address - Street 1:5022 N 54TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-7531
Practice Address - Country:US
Practice Address - Phone:623-931-4343
Practice Address - Fax:623-939-3476
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health