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General NPI Number Information
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NPI Number | 1285311886
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Entity Type | Individual
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Provider Name | SAVANNAH K QUINN MS. LPC, RPT, ICST
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Gender | Female
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1205 MAIN ST
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City | TEXARKANA
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State | TX
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Zip | 75501-4314
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Country | US
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Telephone | 903-792-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 1203 MAIN ST
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City | TEXARKANA
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State | TX
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Zip | 75501-4314
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Country | US
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Telephone | 903-792-2215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 78976
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License Number State | TX
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