Provider Demographics
NPI:1811691058
Name:CORRIVEAU, DONNA QUINN
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:QUINN
Last Name:CORRIVEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:QUINN
Other - Last Name:CORRIVEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DONNA QUINN
Mailing Address - Street 1:122 FOLLY MILL RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4016
Mailing Address - Country:US
Mailing Address - Phone:603-401-8489
Mailing Address - Fax:
Practice Address - Street 1:122 FOLLY MILL RD UNIT B
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4016
Practice Address - Country:US
Practice Address - Phone:603-401-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No171M00000XOther Service ProvidersCase Manager/Care Coordinator