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1861718868
DAVID FULTON QUACKENBUSH
OGDEN, UT
NPI
1861718868
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: UT 7519891-6009)
Enumeration Date
2010-04-15
Last Update Date
2010-04-15
Business Address
Mr. DAVID FULTON QUACKENBUSH CPCI
1140 36TH STREET TRISTAN INC. STE 202
OGDEN, UT 84403
Phone number: 801-392-0004
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Mailing Address
Mr. DAVID FULTON QUACKENBUSH CPCI
452 17TH ST BEHIND 456
OGDEN, UT 84404-5755
Phone number: 801-856-8906
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