Provider Demographics
NPI:1336834290
Name:NORMANDEAU, QUINN GRAELYN
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:GRAELYN
Last Name:NORMANDEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 REMINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6153
Mailing Address - Country:US
Mailing Address - Phone:207-641-3036
Mailing Address - Fax:
Practice Address - Street 1:2795 PILOT KNOB RD STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1930
Practice Address - Country:US
Practice Address - Phone:651-994-9644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1295809366225X00000X
MEOT4494225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist