Provider Demographics
NPI:1912151945
Name:QUALLIOTINE, CAILIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAILIN
Middle Name:
Last Name:QUALLIOTINE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CAILIN
Other - Middle Name:
Other - Last Name:GIBBONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2638
Mailing Address - Country:US
Mailing Address - Phone:413-612-7019
Mailing Address - Fax:
Practice Address - Street 1:7 FLORENCE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-2638
Practice Address - Country:US
Practice Address - Phone:413-612-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11207103TC0700X
MA10907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health