Individual
JIMI BETH OBRETENOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 791-7400
Mailing address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 791-7411
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-210508
SD
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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