Individual
JACOB MARSHALL QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
1300 W LEXINGTON AVE, WINCHESTER, KY 40391-1154
(859) 287-1098
Mailing address
1300 W LEXINGTON AVE, WINCHESTER, KY 40391-1154
(859) 287-1098
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
299921
KY
Other
Enumeration date
09/11/2023
Last updated
09/12/2025
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