Provider Demographics
NPI:1336150671
Name:QUAINTANCE, PAMELA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:QUAINTANCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 MEADOWHILL DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-6618
Mailing Address - Country:US
Mailing Address - Phone:615-542-3599
Mailing Address - Fax:
Practice Address - Street 1:320 E. MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3836
Practice Address - Country:US
Practice Address - Phone:615-542-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730393Medicaid
TN3730393Medicaid