Basic Information
| Provider Information | |||||||||
| NPI: | 1538387519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUINN | ||||||||
| FirstName: | JOHNNA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 OAK CREEK DR | ||||||||
| Address2: | |||||||||
| City: | HOPE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718019125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707225880 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1484 W 1ST ST N | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 718573339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708871078 | ||||||||
| FaxNumber: | 8708870281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P05040267 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.