Individual
SHANA QUINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 BOSTON ST, SALEM, MA 01970-1402
(978) 744-7905
(978) 740-9145
Mailing address
110 BOSTON ST, SALEM, MA 01970-1402
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042104791
CLINICIAN
MA
Enumeration date
04/02/2012
Last updated
04/02/2012
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