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Individual

LILLIE RAYNICE QUARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5386 COX SMITH RD STE A, MASON, OH 45040-6803
(513) 972-5120
Mailing address
LIFESTANCE 5386 COX-SMITH RD SUITE A MASON 45040, MASON, OH 45040-2242
(513) 972-5120

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0028788
OH

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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