Individual
MARVIN LEE BOUSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1818 W FULTON ST, SUITE 201, RAPID CITY, SD 57702-4377
(605) 348-6500
Mailing address
1818 W FULTON ST, SUITE 201, RAPID CITY, SD 57702
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
191
SD
Other
Enumeration date
03/26/2007
Last updated
04/25/2013
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