Provider Demographics
NPI:1801925359
Name:QUINN, LAUREL (MA, MFT)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:MA, MFT
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 M
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93222-0013
Mailing Address - Country:US
Mailing Address - Phone:661-242-7223
Mailing Address - Fax:661-242-1939
Practice Address - Street 1:15908 ZURICH WAY
Practice Address - Street 2:
Practice Address - City:FRAZIER PARK
Practice Address - State:CA
Practice Address - Zip Code:93222-0013
Practice Address - Country:US
Practice Address - Phone:661-242-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17529106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist