Provider Demographics
NPI:1770056202
Name:QUINN, ABIGAIL (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4412
Mailing Address - Country:US
Mailing Address - Phone:814-464-6285
Mailing Address - Fax:
Practice Address - Street 1:2924 WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4412
Practice Address - Country:US
Practice Address - Phone:814-464-6285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016123225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist