Individual
SAMANTHA QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Mailing address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/25/2020
Last updated
04/28/2021
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