Individual
LORI QUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
555 W BROADWAY AVE, FOREST LAKE, MN 55025-1175
(651) 251-5225
Mailing address
29207 SCENIC DR, CHISAGO CITY, MN 55013-8516
(612) 250-1679
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303276
MN
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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