Organization
INTENTIONAL LIFE PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY QUAKENSBUSH DO (PHYSICIAN OWNER)
(940) 277-7373
Entity
Organization
Contact information
Practice address
111 DALLAS ST STE 201, ARGYLE, TX 76226-2701
(940) 277-7373
Mailing address
525 HEMMING RD, VALLEY VIEW, TX 76272-7519
(940) 277-7373
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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