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General NPI Number Information
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NPI Number | 1659086544
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Entity Type | Individual
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Provider Name | DEVON QUINN LMFT-A
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Gender | Female
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 5601 77 CENTER DR STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28217-0717
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Country | US
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Telephone | 704-352-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 3306 N MCDOWELL ST UNIT 3M
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City | CHARLOTTE
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State | NC
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Zip | 28205-1277
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Country | US
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Telephone | 845-596-6563
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12491A
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License Number State | NC
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