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NPI Code Detail

MEDICARE: DEVAN TOBIAS MFT-IT

MEDICARE: DEVAN TOBIAS MFT-IT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist1103-228WI

General Provider Information

NPI Number : 1356184824
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVAN TOBIAS MFT-IT
Provider Business Mailing Address
First Line : 2750 BLUE ASTER BLVD
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-4670
Country : US
Telephone Number : 608-957-3943
Fax Number :
Provider Business Practice Location Address
First Line : 251 PROGRESS WAY STE 102
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2520
Country : US
Telephone Number : 608-849-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2024
Last Update Date : 06/13/2024

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Directions to “ DEVAN TOBIAS MFT-IT” Practice Location

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