Provider Demographics
NPI:1740790591
Name:QUINTANILLA, BLANCA ESTELA (LMSW)
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:ESTELA
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 E JACKSON ST STE 317
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6877
Mailing Address - Country:US
Mailing Address - Phone:956-246-1608
Mailing Address - Fax:
Practice Address - Street 1:513 E JACKSON ST STE 317
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6877
Practice Address - Country:US
Practice Address - Phone:956-246-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based