Individual
DR. ROGER H BELISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3656
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3656
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0810004580
VA
103TC0700X
Clinical Psychologist
36625
TX
103TC0700X
Clinical Psychologist
577
SD
103TF0200X
Forensic Psychologist
0810004580
VA
103TF0200X
Forensic Psychologist
36625
TX
103TF0200X
Forensic Psychologist
577
SD
103TF0200X
Forensic Psychologist
577
—
103TF0200X
Forensic Psychologist
Primary
—
—
Other
Enumeration date
11/24/2010
Last updated
07/25/2023
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