Timothy James Moder, SAC-IT
Timothy James Moder, SAC-IT is an Addiction (Substance Use Disorder) Counselor in Superior, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.
- Licensed in
- WI
- In the registry since
- 2007
Practice location Address checks out
1507 Tower Ave # 307Superior, WI 54880-2532
Phone: (715) 392-9300
Fax: (715) 392-8041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 14242-130 (WI) |
|---|
Record details
| NPI number | 1437332319 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SAC-IT |
| Sole proprietor | No |
| NPI enumerated | December 13, 2007 |
| Last updated in NPPES | December 13, 2007 |
| Mailing address | 1115 Lincoln St, Superior, WI 54880-6730 |
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