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General NPI Number Information
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NPI Number | 1427340744
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Entity Type | Individual
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Provider Name | COLLEEN ANN QUINN PHD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 14 S BRYN MAWR AVE
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City | BRYN MAWR
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State | PA
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Zip | 19010-3216
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Country | US
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Telephone | 215-525-3506
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Fax |
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Provider Business Mailing Address
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Address Line | 8470 LIMEKILN PIKE APT 606
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City | WYNCOTE
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State | PA
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Zip | 19095-2705
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Country | US
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Telephone | 740-334-0072
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6730
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | TPS030088
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License Number State | PA
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