Organization
TARVID COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY S TARVID LCSW (REGISTERED AGENT/MBR)
(414) 491-0377
Entity
Organization
Contact information
Practice address
740 PILGRIM PKWY, SUITE 103, ELM GROVE, WI 53122-2066
(414) 491-0377
Mailing address
7670 W HONEY CREEK PKWY, WEST ALLIS, WI 53219-2738
(414) 491-0377
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7099-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40967200
—
WI
Enumeration date
10/17/2014
Last updated
10/17/2014
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