| NPI | 1477179919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE PETERSON Clinical Social Worker 605-215-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-06-21 |
| Last Update Date | 2020-10-15 |