Quackenbush, Debra Marie
Quackenbush, Debra Marie is an individual health care provider with primary practice located at 1399 S 700 E , Salt Lake City UT 84105-2160. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Quackenbush, Debra Marie can be contacted via phone (801) 832-1050.Contact Information
Primary practice address
1399 S 700 E
Salt Lake City UT 84105-2160
Phone: (801) 832-1050
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 334840-2501 | Utah |
Profile Details
| NPI number | 1720066442 |
|---|---|
| LBN Legal business name | Quackenbush, Debra Marie |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Aug 17th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720066442 | NPPES |
| Utah | Other | 1070011059101 | I H C |
| Utah | Other | 942938348QU1 | I H C |
| Utah | Other | 740411 | I H C |
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