Healthcare Provider Details
I. General information
NPI: 1285823997
Provider Name (Legal Business Name): EILEEN QUINN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 WESCOTT DR HBH 5TH FL
FLEMINGTON NJ
08822-4603
US
IV. Provider business mailing address
2100 WESCOTT DR HBH 5TH FL ATTN LILY
FLEMINGTON NJ
08822-4603
US
V. Phone/Fax
- Phone: 908-788-6401
- Fax: 908-788-6584
- Phone: 908-788-6401
- Fax: 908-788-6584
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 37PC00350400 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: