Most Relevant Information
Provider Data
| NPI Number: | 1003200692 |
| Provider Name: | COURTNEY M QUAST LPC, SAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 17387-130 |
Most Important Dates
| Enumeration Date: | 03/23/2015 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
201 PARK ST
FORT ATKINSON
WI
53538
Practice Location Phone/Fax
| Phone: | 9205639542 |
| Fax: | 9205686047 |
Provider Mailing Location
PO BOX 249
FORT ATKINSON
WI
535380249
Provider Mailing Phone/Fax
| Phone: | 9205685411 |
| Fax: | 9205684004 |