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Individual

LANCE KOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ED.S.

Contact information

Practice address
820 NORTH WASHINGTON AVE, PLEC DAKOTA STATE UNIVERSITY, MADISON, SD 57042
(605) 256-5555
Mailing address
820 NORTH WASHINGTON AVE, PLEC DAKOTA STATE UNIVERSITY, MADISON, SD 57042
(605) 256-5555

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
72674-0
SD

Other

Enumeration date
09/01/2016
Last updated
09/01/2016
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