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Individual

BRIAN MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSW

Contact information

Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 415-3433
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-6700

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4697
SD
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
05/04/2016
Last updated
08/18/2023
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