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Individual

TANIA RHOADS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CISW, SAC

Contact information

Practice address
17 FOREST AVE, SUITE 116, FOND DU LAC, WI 54935-4155
(920) 907-0813
(920) 907-0826
Mailing address
17 FOREST AVE, SUITE 116, FOND DU LAC, WI 54935-4155
(920) 907-0813
(920) 907-0826

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15431-131
WI
104100000X
Social Worker
Primary
901-122
WI

Other

Enumeration date
07/07/2011
Last updated
07/07/2011
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