MEDICARE: DEBORAH DELGADO-QUINTANA MA

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	3398	NC
2	101YP2500X	Professional Counselor	6853	CT
3	103T00000X	Psychologist	3094	PR

General Provider Information

NPI Number	:	1760639975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH DELGADO-QUINTANA MA

Provider Business Mailing Address
First Line	:	9 ELDRED DR
Second Line	:
City	:	EAST HAVEN
State	:	CT
Zip	:	06512-1517
Country	:	US
Telephone Number	:	980-200-1419
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 WEST ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6531
Country	:	US
Telephone Number	:	860-354-8556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2008
Last Update Date	:	02/26/2024

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