Individual
SETH MARWA QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
109 1ST AVENUE, ST. IGNATIUS, MT 59865
(406) 745-3681
Mailing address
109 1ST AVE, ST. IGNATIUS, MT 59865
(406) 745-3681
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-26007
MT
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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