Organization
TABULA RASA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN NEARY (CREDENTIALING)
(518) 244-3737
Entity
Organization
Contact information
Practice address
27094 RIDGEVIEW SPRINGS RD, HOT SPRINGS, SD 57747-6033
(605) 891-4377
Mailing address
27094 RIDGEVIEW SPRINGS RD, HOT SPRINGS, SD 57747-6033
(605) 891-4377
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
12/19/2023
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