Quintin E Poore
Clinical Psychologist Rehabilitation Psychologist
11050 Mount Belvedere Blvd
Fort Drum
, New York 13602-5438
Quintin E Poore
Clinical Psychologist Rehabilitation Psychologist
11050 Mount Belvedere Blvd
Fort Drum
, New York 13602-5438
(315) 772-9292
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About
Features
Specialties
- Clinical Psychologist
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Quintin E Poore
- Usa Meddac 11050 Mount Belvedere Blvd
- Fort Drum, NY
- Zip : 13602
- Phone : (315) 772-9292
Second Address
- Quintin E Poore
- 11050 Mount Belvedere Blvd
- Fort Drum, NY
- Zip : 13602-5438
- Phone : (315) 772-9292
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103G00000X | Clinical Psychologist | 015686-1 | NY |
| N | 103TC0700X | Clinical Psychologist | 015686-1 | NY |
| Y | 103G00000X | Clinical Psychologist | 015686-1 | NY |
| Y | 103TC0700X | Clinical Psychologist | 015686-1 | NY |
| N | 103TR0400X | Rehabilitation Psychologist | 015686-1 | NY |
National Provider Identifier
| NPI | 1689622193 |
|---|---|
| Provider Name | Quintin E Poore |
| First Address | Fort Drum, NY 13602 |
| Second Address | Fort Drum, NY 13602-5438 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/05/2006 |
| Last Update Date | 03/01/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.