Tilden, Penny A

Tilden, Penny A is an individual health care provider with primary practice located at 123 16Th Ave S , Onalaska WI 54650-3109. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Tilden, Penny A can be contacted via phone (608) 775-8646.

Contact Information

Primary practice address
123 16Th Ave S Onalaska WI 54650-3109
Fax:
Website:

Health care specialties

Profile Details

NPI number 1942206446
LBN Legal business name Tilden, Penny A
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942206446 NPPES
Wisconsin MEDICAID 39355900

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