Organization
JAMES W QUILLIN, PHD, APPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WESLEY QUILLIN PHD, MP (PRESIDENT)
(318) 442-7355
Entity
Organization
Contact information
Practice address
1016 CALAIS CIR, ALEXANDRIA, LA 71303-2307
(318) 442-7355
(318) 442-4407
Mailing address
1016 CALAIS CIR, ALEXANDRIA, LA 71303-2307
(318) 442-7355
(318) 442-4407
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0318MP
LA
103TC0700X
Clinical Psychologist
Primary
0318 MP
LA
103TC0700X
Clinical Psychologist
1288
LA
103TC2200X
Clinical Child & Adolescent Psychologist
1288
LA
103TP0016X
Prescribing (Medical) Psychologist
0318MP
LA
1041C0700X
Clinical Social Worker
2498
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
437700719B
BLUE CROSS
LA
Enumeration date
07/22/2011
Last updated
11/26/2014
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