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LESLIE JEAN QUACKENBUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3650 STEVE REYNOLDS BLVD, GWINNETT COMPREHENSIVE MEDICAL CENTER, DULUTH, GA 30096-4506
(919) 764-2000
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005307
GA
1041C0700X
Clinical Social Worker
P004774
NC

Other

Enumeration date
04/14/2011
Last updated
01/10/2022
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