Provider Demographics
NPI:1144660614
Name:QUINATA, SYLVIA T (MA, IMFT)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:T
Last Name:QUINATA
Suffix:
Gender:F
Credentials:MA, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 GOVERNOR CARLOS CAMACHO RD.
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-647-5325
Mailing Address - Fax:671-647-0250
Practice Address - Street 1:790 GOVERNOR CARLOS CAMACHO RD.
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-647-5325
Practice Address - Fax:671-647-0250
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUIMF-127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist