Organization
NIKKI RAE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI ROTH LPC-MH,, LPCC, LAC, (CLINICAL THERAPIST)
(605) 403-4167
Entity
Organization
Contact information
Practice address
3500 S PHILLIPS AVE STE 241, SIOUX FALLS, SD 57105-6863
(605) 403-4167
Mailing address
3500 S PHILLIPS AVE STE 241, SIOUX FALLS, SD 57105-6863
(605) 403-4167
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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