Provider Demographics
NPI:1255927950
Name:STEAD, QAIRA LIN-MARIE (MA)
Entity type:Individual
Prefix:MRS
First Name:QAIRA
Middle Name:LIN-MARIE
Last Name:STEAD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:QAIRA
Other - Middle Name:STEAD
Other - Last Name:CORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:8220 CASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2729
Mailing Address - Country:US
Mailing Address - Phone:267-563-3290
Mailing Address - Fax:215-745-6511
Practice Address - Street 1:8220 CASTOR AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2729
Practice Address - Country:US
Practice Address - Phone:267-563-3290
Practice Address - Fax:215-745-6511
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health