Individual
MARY BETH DORNHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2400 W 49TH ST, SIOUX FALLS, SD 57105-6581
(605) 312-8700
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
173889
MN
1041C0700X
Clinical Social Worker
Primary
19740
MN
1041C0700X
Clinical Social Worker
4781
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000498910
UBH MEDICA
MN
01
—
1356487227
HEATH PARTNERS
MN
01
—
330617000
MINNESOTA HEALTH CARE PROGRAMS
MN
Enumeration date
01/29/2007
Last updated
05/28/2024
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