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Individual

DR. AVIS COURTNEY QUINN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LPC, NCC

Contact information

Practice address
3332 PAMLICO DR, ROANOKE, VA 24018-4931
(540) 257-4429
Mailing address
3332 PAMLICO DR, ROANOKE, VA 24018-4931
(540) 257-4429

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003479
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0701003479
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS LPC
VA
Enumeration date
04/04/2013
Last updated
04/04/2013
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