Provider Demographics
NPI:1659111821
Name:SPEIGHT, QUANTA R
Entity type:Individual
Prefix:DR
First Name:QUANTA
Middle Name:R
Last Name:SPEIGHT
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:PO BOX 83351
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-8019
Mailing Address - Country:US
Mailing Address - Phone:678-713-0495
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 83351
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-8019
Practice Address - Country:US
Practice Address - Phone:678-713-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist