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NPI 1417679796

NPI 1417679796 : CATHY QUINN : DAYTON, TX

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General NPI Number Information
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    NPI Number           |    1417679796
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    Entity Type          |    Individual 
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    Provider Name        |    CATHY QUINN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/14/2022
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    Last Update Date     |    09/14/2022
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Provider Practice Location Address
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    Address Line         |    100 CHERRY CREEK RD 
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    City                 |    DAYTON
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    State                |    TX
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    Zip                  |    77535-1301
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    Country              |    US
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    Telephone            |    917-626-6839
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26854 SQUIRES PARK DR 
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    City                 |    KINGWOOD
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    State                |    TX
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    Zip                  |    77339-6504
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    Country              |    US
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    Telephone            |    917-626-6839
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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        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    102665
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    License Number State |    TX
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