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Individual

HIEDI L ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-PIP

Contact information

Practice address
2412 S CLIFF AVE, SUITE 200, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Mailing address
PO BOX 5045, ATTN: P.F.S. PROV ENROLLMENT, SIOUX FALLS, SD 57117-5045
(605) 322-6400
(605) 322-6499

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
2359
SD
1041C0700X
Clinical Social Worker
Primary
3112
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285967745
DAKOTACARE
05
1285967745
MN
05
1285967745
SD
Enumeration date
09/15/2009
Last updated
08/23/2012
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