Individual
CLIFFORD GARY DAISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
528 QUINCY ST, RAPID CITY, SD 57701-3628
(605) 348-5401
(605) 348-7319
Mailing address
PO BOX 288, RAPID CITY, SD 57709-0288
(605) 348-5401
(605) 348-7319
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1780
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100070
—
SD
Enumeration date
07/19/2006
Last updated
07/08/2007
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