Provider Demographics
NPI:1982074373
Name:MOREHOUSE, QUYNN WISCOMBE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:QUYNN
Middle Name:WISCOMBE
Last Name:MOREHOUSE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 SHORE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1010
Mailing Address - Country:US
Mailing Address - Phone:207-400-5876
Mailing Address - Fax:
Practice Address - Street 1:553 SHORE RD STE 2
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-1010
Practice Address - Country:US
Practice Address - Phone:207-400-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1451103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical