Individual
RONALD K QUALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 774-4600
(701) 774-4620
Mailing address
PO BOX 1266, WILLISTON, ND 58802-1266
(701) 774-4600
(701) 774-4620
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1326
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54516
—
ND
Enumeration date
10/27/2006
Last updated
07/08/2007
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