Provider Demographics
NPI:1083413918
Name:MCQUAID, EMILY VISTA-ANN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:VISTA-ANN
Last Name:MCQUAID
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19741 MCKABBEN LN
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-2616
Mailing Address - Country:US
Mailing Address - Phone:813-990-9950
Mailing Address - Fax:
Practice Address - Street 1:3450 E LAKE RD STE 307
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2411
Practice Address - Country:US
Practice Address - Phone:727-238-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26071101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor