| Doctor Name: | TANIA RHOADS |
| NPI Number: | 1043507346 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CISW, SAC |
| License Number: | 15431-131 |
| Business Practice Address: | 17 Forest Ave Suite 116 Fond Du Lac, WI - 549354155 |
| Business Phone Number: | 9209070813 |
| Business Fax Number: | 9209070826 |
| Mailing Address: | 17 Forest Ave, Suite 116 FOND DU LAC |
| State: | WI |
| Postal Code: | 549354155 |
| Phone Number: | 9209070813 |
| Fax Number: | 9209070826 |
| NPI Enumeration Date: | 07/07/2011 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15431-131 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |