person
Timothy James Moder, SAC-IT
Addiction (Substance Use Disorder) Counselor in Superior, Wisconsin
NPI 1437332319

Timothy James Moder is an Addiction (Substance Use Disorder) Counselor based in Superior, WI and is specialized in Addiction (Substance Use Disorder). Timothy James Moder practices in Superior, WI and has the professional credentials of SAC-IT. The NPI Number for Timothy James Moder is 1437332319 and holds a License No. 14242-130 (Wisconsin).

The current practice location address for Timothy James Moder is 1507 Tower Ave, Superior, WI and can be reached out via phone at 715-392-9300 and via fax at 715-392-8041.

Location: 1507 Tower Ave, Superior, WI, 54880-6730
person
Provider Profile Details
NPI Number
1437332319
Provider Name
Timothy James Moder
Credential
SAC-IT
Provider Entity Type
Individual
Gender
Male
Address
1507 Tower Ave, Superior, WI, 54880-6730
Phone Number
715-392-9300
Fax Number
715-392-8041
Provider Enumeration Date
12/13/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1507 Tower Ave
City
State
Zip
54880-2532
Phone Number
715-392-9300
Fax Number
715-392-8041
person
Provider Business Mailing Address Details
Address
1507 Tower Ave
City
State
Zip
54880-2532
Phone Number
715-392-9300
Fax Number
715-392-8041
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
14242-130 (Wisconsin)
Definition
Definition to come...
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