Provider Demographics
NPI:1932519402
Name:QUINN, ADRIAN PETER (PSYD)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:PETER
Last Name:QUINN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 BROOK LN
Mailing Address - Street 2:
Mailing Address - City:MOHNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19540-7842
Mailing Address - Country:US
Mailing Address - Phone:610-777-1368
Mailing Address - Fax:
Practice Address - Street 1:5026 BROOK LN
Practice Address - Street 2:
Practice Address - City:MOHNTON
Practice Address - State:PA
Practice Address - Zip Code:19540-7842
Practice Address - Country:US
Practice Address - Phone:610-777-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAPS018511103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program