(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003288853
Provider Name: TIA PAINTER CADC
Entity Type: Individual
Taxonomy Code: 101YA0400X
Specialty: Counselor
License Number: 14104
Most Important Dates
Enumeration Date: 10/20/2015
Last Updated: 10/20/2015
Provider Practice Location
1506 31ST AVE N
FORT DODGE
IA
505017274
Practice Location Phone/Fax
Phone: 5155767261
Fax: 5159557652
Provider Mailing Location
1506 31ST AVE N
FORT DODGE
IA
505017274
Provider Mailing Phone/Fax
Phone: 5155767261
Fax: 5159557652