Individual
MR. TREVOR MARK WOLTERSTORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7511 S LOUISE AVE, SIOUX FALLS, SD 57108-5997
(605) 312-8700
(757) 446-8401
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
642
SD
Other
Enumeration date
03/08/2019
Last updated
02/27/2023
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