Individual
DYLAN DETHLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW, QMHP
Contact information
Practice address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-7390
Mailing address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-7390
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6857
SD
1041C0700X
Clinical Social Worker
Primary
6857
SD
Other
Enumeration date
07/25/2023
Last updated
07/08/2026
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