| Doctor Name: | GEORGE QUISENBERRY |
| NPI Number: | 1508889486 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 0959 |
| Business Practice Address: | 512 Bowling Green Rd Scottsville, KY - 421648303 |
| Business Phone Number: | 2702374481 |
| Business Fax Number: | 2702374858 |
| Mailing Address: | 922 State St, P O Box 6499 BOWLING GREEN |
| State: | KY |
| Postal Code: | 421012233 |
| Phone Number: | 2709015000 |
| Fax Number: | 2708425268 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0959 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |