Individual
MACKELLE RENAE GREVENGOED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 E 77TH ST, SIOUX FALLS, SD 57108-3020
(605) 275-0009
Mailing address
4009 W MARY JO PL APT 418, SIOUX FALLS, SD 57108-3521
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6683
SD
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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