| NPI | 1790199594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWARD WHEATON Manager 605-988-8122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: SD LMFT1212) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2021-04-12 |