Provider Demographics
NPI:1154608636
Name:QUINN, JOAN MARIE (OTR)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:QUINN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N4438 VAN TREECK TRL
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53085-2754
Mailing Address - Country:US
Mailing Address - Phone:920-889-9555
Mailing Address - Fax:
Practice Address - Street 1:N4438 VAN TREECK TRL
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN FALLS
Practice Address - State:WI
Practice Address - Zip Code:53085-2754
Practice Address - Country:US
Practice Address - Phone:920-889-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1718225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist