| NPI | 1942496047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ELDON BONTREGER President 605-882-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SD 364) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2011-06-24 |