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BENITA QUAKENBUSH-ROBERTS PH.D.

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1578665626

Individual Registrant:
 BENITA  QUAKENBUSH-ROBERTS PH.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
7852 W 600 N  MENDON, UT 84325-9706 US
Tel: 435-789-3865  Fax: --

Contact information for business:
PO BOX 790102  VERNAL, UT 84079-0102 US
Tel: 435-789-3865  Fax: --

Registration Information:
NPI: 1578665626
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
UT376641-2501

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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