Provider Demographics
NPI:1386846111
Name:DAY, LOUISE (LAC)
Entity Type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 SUMMIT BLVD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5280
Mailing Address - Country:US
Mailing Address - Phone:701-224-1261
Mailing Address - Fax:
Practice Address - Street 1:1138 SUMMIT BLVD
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5280
Practice Address - Country:US
Practice Address - Phone:701-224-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDLAC1257101YA0400X
NDLPCC84-7-1-91-20101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional