Provider Demographics
NPI:1932471273
Name:QUINN, ROBIN NICOLE (BCBA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:NICOLE
Last Name:QUINN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 GRAND RUE DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-2427
Mailing Address - Country:US
Mailing Address - Phone:407-968-8349
Mailing Address - Fax:
Practice Address - Street 1:1717 GRAND RUE DR
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-2427
Practice Address - Country:US
Practice Address - Phone:407-968-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-02-0762103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst