| NPI | 1356032528 |
|---|---|
| Other Name | TERESA RAE QUACKENBUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-11-29 |