Quattlebaum, Justin L

Quattlebaum, Justin L is an sole proprietor health care provider with primary practice located at 109 Bee St , Charleston SC 29401-5703. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Quattlebaum, Justin L can be contacted via phone (310) 890-9930.

Contact Information

Primary practice address
109 Bee St Charleston SC 29401-5703
Phone: (310) 890-9930
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 10001028 South Carolina
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 10001028 South Carolina

Profile Details

NPI number 1780961433
LBN Legal business name Quattlebaum, Justin L
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2011
Last updated Nov 9th, 2011 - about 15 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.

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