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NPI Code Detail

MEDICARE: DEMETRIA QUINN LCSWA

MEDICARE: DEMETRIA QUINN LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP018895NC

General Provider Information

NPI Number : 1114515376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMETRIA QUINN LCSWA
Provider Business Mailing Address
First Line : 1216 MANN DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-5512
Country : US
Telephone Number : 980-262-3043
Fax Number : 980-339-5617
Provider Business Practice Location Address
First Line : 1216 MANN DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-5512
Country : US
Telephone Number : 980-262-3043
Fax Number : 980-339-5617
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2021
Last Update Date : 05/17/2023

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Directions to “ DEMETRIA QUINN LCSWA” Practice Location

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