Individual
BETH M MICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2501 W 26TH ST, SIOUX FALLS, SD 57105-2446
(605) 782-2300
(605) 782-2301
Mailing address
2501 W 26TH ST, SIOUX FALLS, SD 57105-2446
(605) 782-2300
(605) 782-2301
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0464
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101K4MI
BLUE CROSS BLUE SHIELD MN
SD
01
—
1907880
ARAZ
SD
01
—
31685
SIOUX VALLEY HEALTH PLANS
SD
01
—
4994834
BLUE CROSS BLUE SHIELD SD
SD
01
—
4996085
BLUE CROSS BLUE SHIELD SD
SD
01
—
4996086
BLUE CROSS BLUE SHIELD SD
SD
01
—
4996087
BLUE CROSS BLUE SHIELD SD
SD
05
—
5834110
—
SD
05
—
5834112
—
SD
05
—
5834113
—
SD
05
—
5834114
—
SD
01
—
64-04068
MEDICA
SD
01
—
64-04069
MEDICA
SD
01
—
64-04070
MEDICA
SD
01
—
64-05328
MEDICA
SD
Enumeration date
09/23/2005
Last updated
03/31/2008
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