Organization
PSYCHODYNAMIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA GOUBANOVA (LPC)
(605) 254-4789
Entity
Organization
Contact information
Practice address
3610 S WESTERN AVE STE 2, SIOUX FALLS, SD 57105-6143
(605) 254-4789
Mailing address
3610 S WESTERN AVE STE 2, SIOUX FALLS, SD 57105-6143
(605) 254-4789
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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