# MS. STACY QUINT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1457308074
- **Gender:** F
- **Credential:** PSYD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 20041873A | IN | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 05/07/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000300322 | ANTHEM PROVIDER NUMBER | IN |
| 05 | — | 200450480 | — | IN |
| 01 | — | 585677000 | MAGELLAN HEALTH PROVIDER | IN |