Individual
NIKKI BLACK BEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1000 HEALTH CENTER ROAD, KYLE, SD 57752-0540
(605) 455-2451
(605) 455-2808
Mailing address
PO BOX 540, KYLE, SD 57752-0540
(605) 455-2451
(605) 455-2808
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC20179
SD
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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