Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 3075 | SD |
NPI | 1003215757 |
---|---|
Provider Name | Malia Holbeck |
First Address | Sioux Falls, SD 57117-5045 |
Second Address | Sioux Falls, SD 57105-4031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 19/08/2014 |