Individual
DERRIC OLIVER RUNNING HORSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACT
Contact information
Practice address
1520 HAINES AVE STE 9, RAPID CITY, SD 57701-0710
(605) 716-7841
Mailing address
1520 HAINES AVE STE 91520N, RAPID CITY, SD 57701-0710
(605) 716-7841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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