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1013644137
THEODORE DANIEL HOSTIKKA
SIOUX CITY, IA
NPI
1013644137
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: IA 21R015)
Enumeration Date
2022-08-08
Last Update Date
2022-08-08
Business Address
THEODORE DANIEL HOSTIKKA M.S., LADC, IADC
3500 W 4TH ST
SIOUX CITY, IA 51103-3203
Phone number: 712-226-1899
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Mailing Address
THEODORE DANIEL HOSTIKKA M.S., LADC, IADC
1021 N MULFORD RD
ROCKFORD, IL 61107-3874
Phone number:
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