Individual
THEODORE DANIEL HOSTIKKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., LADC, IADC
Contact information
Practice address
3500 W 4TH ST, SIOUX CITY, IA 51103-3203
(712) 226-1899
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3874
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21R015
IA
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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