Individual
LACEY JEAN QUALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1407 SAINT ANDREW ST, SUITE 100, LA CROSSE, WI 54603-3301
(608) 785-6266
Mailing address
615 MCHUGH RD APT 7, HOLMEN, WI 54636-9393
(715) 271-8197
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
12047-120
WI
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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