Individual
MR. TODD D MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW-PIP
Contact information
Practice address
123 19TH ST NE, WATERTOWN, SD 57201
(605) 886-0123
(605) 886-5447
Mailing address
123 19TH ST NE, WATERTOWN, SD 57201-2823
(605) 886-0123
(605) 886-5477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16095
MN
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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