Individual
BENITA QUAKENBUSH-ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7852 W 600 N, MENDON, UT 84325-9706
(435) 789-3865
Mailing address
PO BOX 790102, VERNAL, UT 84079-0102
(435) 789-3865
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
376641-2501
UT
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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