Provider Demographics
NPI:1023608569
Name:QUINN, ARIEL ELIZABETH
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:ELIZABETH
Last Name:QUINN
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 1:1995 MARK TWAIN CIR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-1538
Mailing Address - Country:US
Mailing Address - Phone:484-894-4503
Mailing Address - Fax:
Practice Address - Street 1:3865 ADLER PL
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9000
Practice Address - Country:US
Practice Address - Phone:610-867-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002092251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health