Quillen, Marc A
Quillen, Marc A is an sole proprietor health care provider with primary practice located at 4217 Briarwood Dr , Lawrence KS 66049-1998. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Quillen, Marc A can be contacted via phone (785) 856-0684.Contact Information
Primary practice address
4217 Briarwood Dr
Lawrence KS 66049-1998
Phone: (785) 856-0684
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 0521 | Kansas |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0521 | Kansas |
Profile Details
| NPI number | 1427053784 |
|---|---|
| LBN Legal business name | Quillen, Marc A |
| Credentials | PH.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Mar 23rd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427053784 | NPPES |
| Kansas | MEDICAID | 100230310B |
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