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Individual

DR. MITTIE QUINN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3925 OLD LEE HWY, SUITE 52A, FAIRFAX, VA 22030-2426
(703) 385-7575
(703) 385-7578
Mailing address
3925 OLD LEE HWY, SUITE 52A, FAIRFAX, VA 22030-2426
(703) 385-7575
(703) 385-7578

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701003340
VA
103TS0200X
School Psychologist
Primary
0803000080
VA

Other

Enumeration date
10/06/2006
Last updated
01/27/2011
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