Provider Demographics
NPI:1871300558
Name:O'QUINN, WESLEY ALLEN (MS, LMFT - ASSOCIATE)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:ALLEN
Last Name:O'QUINN
Suffix:
Gender:M
Credentials:MS, LMFT - ASSOCIATE
Other - Prefix:
Other - First Name:WESLEY
Other - Middle Name:ALLEN
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8008 SLIDE RD STE 14
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2828
Mailing Address - Country:US
Mailing Address - Phone:806-223-2753
Mailing Address - Fax:
Practice Address - Street 1:8008 SLIDE RD STE 14
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2828
Practice Address - Country:US
Practice Address - Phone:806-223-2753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205662106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist