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1023662459
DOMENICK TIRABASSI
FOND DU LAC, WI
NPI
1023662459
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103T00000X Psychologist
(Licence: WI 5089-57)
Enumeration Date
2019-07-24
Last Update Date
2024-08-31
Business Address
Dr. DOMENICK TIRABASSI PsyD
420 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-8492
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Mailing Address
Dr. DOMENICK TIRABASSI PsyD
420 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone number: 920-926-8492
Copy
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