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NPI Code Detail

MEDICARE: MACKENZIE IRENE QUINTON

MEDICARE: MACKENZIE IRENE QUINTON
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 WorkerC019172NC

General Provider Information

NPI Number : 1477166551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE IRENE QUINTON
Provider Business Mailing Address
First Line : 1817 SIR TYLER DR APT 212
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-8544
Country : US
Telephone Number : 425-773-4458
Fax Number :
Provider Business Practice Location Address
First Line : 750 N FREEDOM BLVD
Second Line :
City : PROVO
State : UT
Zip : 84601-1677
Country : US
Telephone Number : 801-373-4760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 02/04/2026

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Directions to “ MACKENZIE IRENE QUINTON ” Practice Location

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