Individual
MS. STARDUST H RED BOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
113 COMANCHE RD, FM-116, FORT MEADE, SD 57741
(605) 490-9704
Mailing address
113 COMANCHE RD, FM-116, FORT MEADE, SD 57741
(605) 490-9704
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13045782-3501
UT
Other
Enumeration date
12/23/2008
Last updated
04/29/2025
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