Provider Demographics
NPI:1013422062
Name:QUINONES, DONETTA D
Entity Type:Individual
Prefix:
First Name:DONETTA
Middle Name:D
Last Name:QUINONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 NE 410 INTERSTATE LOOP, STE. 203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5268
Mailing Address - Country:US
Mailing Address - Phone:888-332-4166
Mailing Address - Fax:
Practice Address - Street 1:84 NE 410 INTERSTATE LOOP, STE. 203
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5268
Practice Address - Country:US
Practice Address - Phone:888-332-4166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA100873Medicaid