Individual provider · Type 1 NPI
Tristan Albert Ertman, SAC-IT
Addiction (Substance Use Disorder) Counselor · Kiel, WI
NPI number
1780262840
Active
Practice location
530 State Road 67
Kiel, WI 53042-1650
Fax (920) 894-1373
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 19029-130 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1780262840
Tristan Albert Ertman, SAC-IT's National Provider Identifier is 1780262840, issued on Mar 31, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kiel, WI. The record was last updated on Mar 31, 2021.