Individual
JOSITA THERESE HARRIS QUIDACHAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LCSW-E
Contact information
Practice address
BONNINS BLVD, BLDG 21028, YIGO, GU 96929
(671) 362-4704
Mailing address
254 ABG, UNIT 14021, APO, AP 96543
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-E-007
GU
1041C0700X
Clinical Social Worker
Primary
LCSW-E-017
GU
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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