Provider Demographics
NPI:1588411730
Name:O'BRIAN, QUINN (LISW)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:
Last Name:O'BRIAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6367 DOROTHYS DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4813
Mailing Address - Country:US
Mailing Address - Phone:563-396-6331
Mailing Address - Fax:
Practice Address - Street 1:321 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52801-1409
Practice Address - Country:US
Practice Address - Phone:563-888-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0983831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty