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General NPI Number Information
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NPI Number | 1275908790
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Entity Type | Individual
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Provider Name | KRISTY MARIE QUACKENBUSH ORR PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 3305 SW 34TH CIR SUITE 101
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City | OCALA
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State | FL
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Zip | 34474-6616
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Country | US
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Telephone | 800-346-8677
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 SW 34TH CIR SUITE 101
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City | OCALA
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State | FL
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Zip | 34474-6616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9422
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License Number State | FL
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