NPI | 1629419593 |
---|---|
Former Name | MAGGI QUACKENBUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 5040273-3902) |
Enumeration Date | 2013-07-08 |
Last Update Date | 2018-03-17 |