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NPI Code Detail

MEDICARE: AMELIA QUIGLEY MS

MEDICARE: AMELIA QUIGLEY MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2133V00000XRegistered Dietitian5332MA

General Provider Information

NPI Number : 1518503382
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA QUIGLEY MS
Provider Business Mailing Address
First Line : 6 HOWLAND ST APT 4
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-2554
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1650 SPRUCE ST STE 205
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-7402
Country : US
Telephone Number : 760-815-7772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2019
Last Update Date : 01/31/2022

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