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Organization
MARK W. PERRENOUD PH.D. INC.
Active
Organization
MARK W. PERRENOUD PH.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WILLIAM PERRENOUD PHD (PRESIDENT)
(605) 348-6500
Entity
Organization
Contact information
Practice address
1818 WEST FULTON, SUITE 201, RAPID CITY, SD 57702-4347
(605) 348-6500
(605) 341-7409
Mailing address
1818 WEST FULTON, SUITE 201, RAPID CITY, SD 57702-4347
(605) 348-6500
(605) 341-7409
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
316
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6550895
—
SD
Enumeration date
03/28/2012
Last updated
03/28/2012
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