| Sandbulte Llc | |
|
1601 E. 69th Str Suite 101 Sioux Falls SD 57108 | |
| (605) 906-3329 | |
| (877) 814-0028 |
| Full Name | Sandbulte Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1601 E. 69th Str, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Shelley Lynn Sandbulte (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6059063329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandbulte Llc 1601 E 69th Str. Suite 101 Sioux Falls SD 57108-8322 Ph: (605) 906-3329 | Sandbulte Llc 1601 E. 69th Str Suite 101 Sioux Falls SD 57108 Ph: (605) 906-3329 |
| NPI Number | 1184303208 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/15/2023 |
| Medicare PECOS PAC ID | 1850835786 |
|---|---|
| Medicare Enrollment ID | O20240702001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184303208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Shelley L Sandbulte |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871587253 PECOS PAC ID: 0749299105 Enrollment ID: I20060412000388 |
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