Provider Demographics
NPI:1043845019
Name:QUINN, EILEEN C
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:C
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:ANN
Other - Last Name:COUDREAUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, MS
Mailing Address - Street 1:323 VALLEY BROOK RD.
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002
Mailing Address - Country:US
Mailing Address - Phone:215-654-7577
Mailing Address - Fax:
Practice Address - Street 1:323 VALLEY BROOK RD.
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002
Practice Address - Country:US
Practice Address - Phone:215-654-7577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst