Individual
TIA L SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9401 W BELOIT RD STE 201, MILWAUKEE, WI 53227-4357
(414) 499-5765
Mailing address
4113 N 100TH ST, MILWAUKEE, WI 53222-1311
(414) 499-5765
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7097-226
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/12/2019
Last updated
11/30/2022
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