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1205210044
MICHAEL ALLAN QUAKENBUSH
LEMON GROVE, CA
NPI
1205210044
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-07-10
Last Update Date
2015-07-10
Business Address
-- MICHAEL ALLAN QUAKENBUSH
2049 SKYLINE DR
LEMON GROVE, CA 91945-4221
Phone number: 619-442-0277
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Mailing Address
-- MICHAEL ALLAN QUAKENBUSH
2049 SKYLINE DR
LEMON GROVE, CA 91945-4221
Phone number: 619-442-0277
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