Provider Demographics
NPI:1841908266
Name:QUAINOO, MARIE (COTA)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:QUAINOO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 AMERICAN AVE APT E309
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4013
Mailing Address - Country:US
Mailing Address - Phone:610-805-4480
Mailing Address - Fax:
Practice Address - Street 1:640 AMERICAN AVE APT E309
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4013
Practice Address - Country:US
Practice Address - Phone:610-805-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010260224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant