Healthcare Provider Details

I. General information

NPI: 1023622537
Provider Name (Legal Business Name): QUINN MASSETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 IRIS CT
NEWARK DE
19713-1073
US

IV. Provider business mailing address

1 IRIS CT
NEWARK DE
19713-1073
US

V. Phone/Fax

Practice location:
  • Phone: 443-907-9954
  • Fax:
Mailing address:
  • Phone: 443-907-9954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberU2-0002102
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: