Individual
CAROLYN SUE WILDHABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW-PIP
Contact information
Practice address
224 ELK STREET, RAPID CITY, SD 57701
(605) 755-7710
(605) 755-7719
Mailing address
224 ELK STREET, RAPID CITY, SD 57701
(605) 755-7710
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3442
SD
1041C0700X
Clinical Social Worker
3442
SD
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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