| NPI | 1679574578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH G BLACKINTON Director 605-665-0841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 401) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD 2127) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SD 1845) | |
| 103TC0700X Psychologist, Clinical (Licence: SD 250) | |
| 103TC0700X Psychologist, Clinical (Licence: SD 456) | |
| 101YM0800X Counselor, Mental Health (Licence: SD 2118) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-08-22 |