Basic Information
| Provider Information | |||||||||
| NPI: | 1083387880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUINN | ||||||||
| FirstName: | COLLEEN | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 THORNTON ST | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021703413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174558180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 49 WALNUT ST BLDG 3 | ||||||||
| Address2: | |||||||||
| City: | WELLESLEY HILLS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024812108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812390100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2021 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 13309 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.