Provider Demographics
NPI:1366159253
Name:QUINONES, SIOBHAN CRYSTAL (MSW)
Entity type:Individual
Prefix:MS
First Name:SIOBHAN
Middle Name:CRYSTAL
Last Name:QUINONES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROOSEVELT AVE APT A2
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-3429
Mailing Address - Country:US
Mailing Address - Phone:848-250-9157
Mailing Address - Fax:
Practice Address - Street 1:1036 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2870
Practice Address - Country:US
Practice Address - Phone:732-532-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty