Individual
TIA DVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LMFT
Contact information
Practice address
18336 JOPLIN ST NW, ELK RIVER, MN 55330-1773
(763) 350-9687
(651) 447-5394
Mailing address
18336 JOPLIN ST NW, ELK RIVER, MN 55330-1773
(763) 350-9687
(651) 447-5394
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2822
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2822
—
MN
Enumeration date
07/31/2015
Last updated
04/03/2024
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