| Doctor Name: | STEPHANIE QUICK |
| NPI Number: | 1083036305 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC |
| License Number: | 3358 |
| Business Practice Address: | 405 Brooklyn St Superior, MT - 598729607 |
| Business Phone Number: | 4065329150 |
| Business Fax Number: | |
| Mailing Address: | 3255 Lt Moss Rd, MISSOULA |
| State: | MT |
| Postal Code: | 598047220 |
| Phone Number: | 4065329150 |
| Fax Number: | |
| NPI Enumeration Date: | 01/07/2014 |
| NPI Last Update Date: | 01/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 3358 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |