Provider Demographics
NPI:1104105378
Name:LORETTA, QUINBE ASHLEY-ANN (MS, ED, PPS)
Entity type:Individual
Prefix:MISS
First Name:QUINBE
Middle Name:ASHLEY-ANN
Last Name:LORETTA
Suffix:
Gender:F
Credentials:MS, ED, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19736 E BELLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3422
Mailing Address - Country:US
Mailing Address - Phone:720-203-0855
Mailing Address - Fax:
Practice Address - Street 1:10350 DRANSFELDT RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9673
Practice Address - Country:US
Practice Address - Phone:303-730-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016354101YM0800X
COLPC.0016354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health