Individual provider · Type 1 NPI

Timothy James Moder, SAC-IT

Addiction (Substance Use Disorder) Counselor · Superior, WI

NPI number 1437332319 Active

Practice location

1507 Tower Ave, # 307
Superior, WI 54880-2532

Call (715) 392-9300 Map

Fax (715) 392-8041

Mailing address

1115 Lincoln St
Superior, WI 54880-6730

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X14242-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1437332319

Timothy James Moder, SAC-IT's National Provider Identifier is 1437332319, issued on Dec 13, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Superior, WI. The record was last updated on Dec 13, 2007.