| NPI | 1043718679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI DELAYNE KINZELL Clinical Social Worker 605-490-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SD 3129) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2024-01-10 |