Provider Demographics
NPI:1487344461
Name:BUTLER, QUINCI ANNE
Entity type:Individual
Prefix:
First Name:QUINCI
Middle Name:ANNE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7781 PENINSULAR DR
Mailing Address - Street 2:
Mailing Address - City:FARWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48622-9418
Mailing Address - Country:US
Mailing Address - Phone:989-289-4907
Mailing Address - Fax:
Practice Address - Street 1:7781 PENINSULAR DR
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:MI
Practice Address - Zip Code:48622-9418
Practice Address - Country:US
Practice Address - Phone:989-289-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician