Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1053734111 |
---|---|
Provider Name | Mollie Ronge |
First Address | Sioux Falls, SD 57117-5046 |
Second Address | Sioux Falls, SD 57105-1305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2014 |
Last Update Date | 27/01/2014 |