Provider Demographics
NPI:1699097147
Name:QUINTANAR, STEPHANIE ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:QUINTANAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-4719
Mailing Address - Country:US
Mailing Address - Phone:325-280-3502
Mailing Address - Fax:325-695-5200
Practice Address - Street 1:2401 S WILLIS ST
Practice Address - Street 2:STE. 103
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6270
Practice Address - Country:US
Practice Address - Phone:325-695-5200
Practice Address - Fax:325-695-5200
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63917106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist