Individual
SCOTT FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
11367 QUINCE ST NW, COON RAPIDS, MN 55448-3246
(763) 614-8381
Mailing address
11367 QUINCE ST NW, COON RAPIDS, MN 55448-3246
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304279
MN
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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