| Vanessa Iverson, Llc | |
|
115 S Main Ave Wagner SD 57380-2001 | |
| (605) 670-3104 | |
| Not Available |
| Full Name | Vanessa Iverson, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 115 S Main Ave, Wagner, South Dakota |
| Authorized Official Name and Position | Vanessa Iverson (OWNER/THERAPIST) |
| Authorized Official Contact | 6056703104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanessa Iverson, Llc 115 S Main Ave Wagner SD 57380-2001 Ph: (605) 670-3104 | Vanessa Iverson, Llc 115 S Main Ave Wagner SD 57380-2001 Ph: (605) 670-3104 |
| NPI Number | 1245856632 |
|---|---|
| Provider Enumeration Date | 06/22/2020 |
| Last Update Date | 09/22/2020 |
| Certification Date | 09/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245856632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Yankton Sioux Tribe Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Main Sw, Wagner, SD 57380 Phone: 605-384-3641 Fax: 605-384-5687 |