| Doctor Name: | TAMI JOE DELISLE |
| NPI Number: | 1609242825 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSAT |
| License Number: | 2621-226 |
| Business Practice Address: | 5979 Siggelkow Rd Mc Farland, WI - 535589817 |
| Business Phone Number: | 6088388999 |
| Business Fax Number: | |
| Mailing Address: | Po Box 229, REESEVILLE |
| State: | WI |
| Postal Code: | 535790229 |
| Phone Number: | 9203820445 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2015 |
| NPI Last Update Date: | 08/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2621-226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |