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Individual

JODIE TIRADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
W9850 AIRPORT RD., BLACK RIVER FALLS, WI 54615-0918
(715) 284-9851
Mailing address
PO BOX 918, BLACK RIVER FALLS, WI 54615-0918
(715) 284-9851

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17348-130
WI

Other

Enumeration date
08/11/2015
Last updated
08/11/2015
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