Individual
MR. MATTHEW JOSEPH QUACKENBUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.S.W.
Contact information
Practice address
5288 S ALLENDALE DR, MURRAY, UT 84123-4536
(801) 857-0790
Mailing address
5288 S ALLENDALE DR, MURRAY, UT 84123-4536
(801) 857-0790
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10148006-3506
UT
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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