Individual
MR. QUENDERRION MARQUEZ WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
124 S MAIN ST, JONESBORO, GA 30236-3599
(404) 695-2195
Mailing address
PO BOX 1243, JACKSON, GA 30233-0026
(404) 695-2195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Enumeration date
01/17/2019
Last updated
01/18/2019
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