Individual
CHARISSE NICHELLE BORDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 253, ROSEBUD, SD 57570-0253
(605) 515-3511
Mailing address
PO BOX 253, ROSEBUD, SD 57570-0253
(605) 515-3511
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/11/2016
Last updated
12/01/2025
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