Individual
MR. ERIC TABAMO GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, MFT
Contact information
Practice address
2009 5TH ST, MONROE, WI 53566-1546
(608) 324-2000
Mailing address
324 RIVER ST, PORTAGE, WI 53901-1946
(608) 617-4173
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
974-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558694125
—
WI
Enumeration date
09/14/2009
Last updated
10/30/2024
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