Organization · Type 2 NPI
Theodore R. Liautaud
Mental Health Counselor · Lake View, IA
NPI number
1487779575
Active
Practice location
421 E Shore Dr
Lake View, IA 51450
Fax (712) 657-2106
Mailing address
PO Box 710, 421 E Shore Dr
Lake View, IA 51450
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 01790 (IA) |
| Psychiatry Physician | 2084P0800X | 01790 (IA) |
Mental Health Counselor: Definition to come...
Another provider at this address
About NPI 1487779575
Theodore R. Liautaud's National Provider Identifier is 1487779575, issued on Mar 20, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lake View, IA. The record was last updated on Sep 30, 2008.