Individual
DR. TAWA M WITKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
701 E 6TH ST, MCLAUGHLIN CLINIC, MCLAUGHLIN, SD 57642
(605) 823-4458
(605) 823-4459
Mailing address
PO BOX 879, MCLAUGHLIN CLINIC, MC LAUGHLIN, SD 57642-0879
(605) 823-4458
(605) 823-4459
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
456
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10025457300
NEBRASKA MEDICAID
—
01
—
14283
AVERA HEALTH PLAN
—
01
—
246779
AETNA
—
01
—
456
DAKOTA CARE
—
01
—
4994787
BLUE CROSS
—
05
—
6552242
—
SD
01
—
DB3096
UNITED HEALTHCARE
—
Enumeration date
12/11/2006
Last updated
01/27/2011
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