Individual
MIA WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 SAINT JOSEPH ST, RAPID CITY, SD 57701-2822
(605) 394-1813
Mailing address
21 SAINT JOSEPH ST, RAPID CITY, SD 57701-2822
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0534
SD
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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