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Organization

QUINEIFORM LLC

Active
Other names
Quinn Sullivan PsyD, LP
Organization subpart
No

Provider details

NPI number
Authorized official
QUINN SULLIVAN PSYD (CLINICAL PSYCHOLOGIST)
(651) 343-4800
Entity
Organization

Contact information

Practice address
8519 EAGLE POINT BLVD, SUITE 150, LAKE ELMO, MN 55042-8629
(651) 343-4800
(877) 992-0282
Mailing address
8519 EAGLE POINT BLVD, SUITE 150, LAKE ELMO, MN 55042-8629
(651) 343-4800
(877) 992-0282

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5493
MN

Other

Enumeration date
11/10/2014
Last updated
11/10/2014
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