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Organization
THEODORE R. LIAUTAUD
Active
Organization
THEODORE R. LIAUTAUD
Active
Other names
Lakes Counseling & Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE R. LIAUTAUD DO (OWNER)
(712) 657-2211
Entity
Organization
Contact information
Practice address
421 E SHORE DR, LAKE VIEW, IA 51450
(712) 657-2211
(712) 657-2106
Mailing address
PO BOX 710, 421 E SHORE DR, LAKE VIEW, IA 51450
(712) 657-2211
(712) 657-2106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
01790
IA
2084P0800X
Psychiatry Physician
01790
IA
Other
Enumeration date
03/20/2007
Last updated
09/30/2008
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