Individual
KATY MAY ALLEN QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 SAWGRASS CORPORATE PKWY, SUITE 106, SUNRISE, FL 33325-6244
(954) 745-1112
(954) 745-1120
Mailing address
209 N FT LAUDERDALE BCH BLVD, APARTMENT 10D, FORT LAUDERDALE, FL 33304-4365
(954) 309-6129
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI1999
FL
Other
Enumeration date
09/25/2011
Last updated
09/25/2011
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