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General NPI Number Information
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NPI Number | 1831682392
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Entity Type | Individual
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Provider Name | STEPHANIE KIERSTEAD QUINN LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/10/2018
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Last Update Date | 06/10/2018
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Provider Practice Location Address
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Address Line | 190 OLD DERBY ST
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City | HINGHAM
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State | MA
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Zip | 02043-4006
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Country | US
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Telephone | 207-939-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 22 PROSPECT ST
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City | NORWELL
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State | MA
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Zip | 02061-1141
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Country | US
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Telephone | 207-939-8250
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 115817
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License Number State | MA
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