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Individual

KAY QUINTERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LSPE

Contact information

Practice address
612 S CONGRESS BLVD, SUITE F, SMITHVILLE, TN 37166-2009
(615) 597-4673
(615) 597-4673
Mailing address
612 S CONGRESS BLVD, SUITE F, SMITHVILLE, TN 37166-2009
(615) 597-4673
(615) 597-4673

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0000000703
TN
101YP2500X
Professional Counselor
0000000703
TN
103T00000X
Psychologist
0000000703
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1274688
AMERIGROUP
TN
01
2500723
TENN CARE SELECT
TN
01
26-4275807
TAX ID
TN
01
4222377
BLUE CROSS BLUE SHIELD
TN
05
5441718
TN
Enumeration date
04/03/2007
Last updated
06/07/2011
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