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Individual

GEORGE QUISENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
512 BOWLING GREEN RD, SCOTTSVILLE, KY 42164-8303
(270) 237-4481
(270) 237-4858
Mailing address
922 STATE ST, P O BOX 6499, BOWLING GREEN, KY 42101-2233
(270) 901-5000
(270) 842-5268

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0959
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30604011
KY
Enumeration date
07/25/2006
Last updated
07/09/2007
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