MICHAEL QUACKENBUSH

UKIAH, CA
NPI1134299027
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  LCS20950)
Additional Taxonomies103T00000X Psychologist
(Licence: CA  20950)
Enumeration Date2006-11-08
Last Update Date2007-07-08
Business Address
-- MICHAEL QUACKENBUSH LCSW
333 LAWS AVE
UKIAH, CA 95482-6540
Phone number: 707-468-1010
Mailing Address
-- MICHAEL QUACKENBUSH LCSW
333 LAWS AVE
UKIAH, CA 95482-6540
Phone number: 707-468-1010