Healthcare Provider Details

I. General information

NPI: 1679104681
Provider Name (Legal Business Name): JOY MARIE QUAINTANCE PSYCH. ASS.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 REISTERSTOWN RD
PIKESVILLE MD
21208-1379
US

IV. Provider business mailing address

1848 REISTERSTOWN RD
PIKESVILLE MD
21208-1379
US

V. Phone/Fax

Practice location:
  • Phone: 443-761-5000
  • Fax:
Mailing address:
  • Phone: 443-761-5000
  • Fax: 887-977-0511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA0567
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: