Individual
JIA JIAN TIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4071-57
WI
Other
Enumeration date
04/05/2021
Last updated
10/25/2022
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