MEDICARE: MRS. DEBORAH MCGRAW QUINTON L.C.S.W.

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
1	1041C0700X	Clinical Social Worker	CSW002588	GA

General Provider Information

NPI Number	:	1669598132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH MCGRAW QUINTON L.C.S.W.

Provider Business Mailing Address
First Line	:	1125 S GREEN ST
Second Line	:
City	:	THOMASTON
State	:	GA
Zip	:	30286-4617
Country	:	US
Telephone Number	:	706-648-2054
Fax Number	:

Provider Business Practice Location Address
First Line	:	463 ERNEST BILES DR
Second Line	:	SUITE B
City	:	JACKSON
State	:	GA
Zip	:	30233-2229
Country	:	US
Telephone Number	:	770-775-6645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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