Individual
LYNN A QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
268 STILLWATER AVE, ACADIA HOSPITAL CORP., BANGOR, ME 04401-3945
(207) 973-6100
(207) 973-6109
Mailing address
12301 S MAIN ST, THE MENNINGER CLINIC, HOUSTON, TX 77035-6207
(713) 275-5000
(207) 973-6109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7004
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104000000
—
ME
Enumeration date
09/22/2006
Last updated
08/13/2018
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