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Individual

KAMBRA DEITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-PIP, RPT-S

Contact information

Practice address
2138 JACKSON BLVD, RAPID CITY, SD 57702-3495
(605) 718-0488
Mailing address
4698 S PLACITA DOS PAJARITOS, TUCSON, AZ 85730-5812
(605) 718-0488
(605) 309-8033

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4931
SD
104100000X
Social Worker
5062
ND
1041C0700X
Clinical Social Worker
4931
SD
1041C0700X
Clinical Social Worker
5062
ND

Other

Enumeration date
01/05/2016
Last updated
12/11/2025
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