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Individual

TIMOTHY PAUL TINIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5177
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 333-5177

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 0251
MN
103TC0700X
Clinical Psychologist
LP0251
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
075J1TI 075J6TI
BCBS PROVIDER PIN
MN
05
599352100
MN
01
61-21170
MEDICA PIN
MN
Enumeration date
08/31/2006
Last updated
02/07/2025
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