Healthcare Provider Details

I. General information

NPI: 1437854114
Provider Name (Legal Business Name): HANNAH QUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451B US HIGHWAY 17
RICHMOND HILL GA
31324-3397
US

IV. Provider business mailing address

100 COMMERCE CT
POOLER GA
31322-9445
US

V. Phone/Fax

Practice location:
  • Phone: 912-312-7409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA003033
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: