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Individual

MRS. GERTRUDE BOITUMELO MAKGABENYANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CLINICAL MENTAL

Contact information

Practice address
123 19TH ST NE, WATERTOWN, SD 57201
(605) 886-0123
(605) 886-5447
Mailing address
8790 F ST, OMAHA, NE 68127-1524
(531) 444-9861
(605) 886-5447

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12537
NE
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013613322
NPI
05
5200010
SD
Enumeration date
08/21/2007
Last updated
02/17/2026
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