Provider Demographics
NPI:1699048660
Name:QUINONES, NORMA ENID (PTA)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:ENID
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:NORMA
Other - Middle Name:ENID
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1200 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1036
Mailing Address - Country:US
Mailing Address - Phone:816-781-3020
Mailing Address - Fax:
Practice Address - Street 1:1200 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1036
Practice Address - Country:US
Practice Address - Phone:816-781-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115825225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant