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General NPI Number Information
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NPI Number | 1467075879
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Entity Type | Individual
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Provider Name | QUINCY M TOBON
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 8208 GARDEN CATALINA CIR APT 1914
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City | LAKE WORTH
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State | FL
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Zip | 33467-6765
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Country | US
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Telephone | 561-403-3994
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Fax |
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Provider Business Mailing Address
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Address Line | 3986 W SANDPIPER DR APT 8
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-2479
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Country | US
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Telephone | 561-781-1369
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 19-80128
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License Number State | FL
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