Provider Demographics
NPI:1982459418
Name:LINDQUIST, LESLIE JOAN
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JOAN
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 4TH AVE NE UNIT 19
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2400
Mailing Address - Country:US
Mailing Address - Phone:701-662-7052
Mailing Address - Fax:701-662-3360
Practice Address - Street 1:524 4TH AVE NE UNIT 19
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2400
Practice Address - Country:US
Practice Address - Phone:701-662-7052
Practice Address - Fax:701-662-3360
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator