Individual
MAHALA FAITH DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 ELK ST, RAPID CITY, SD 57701-7351
(605) 343-7262
Mailing address
350 ELK ST, RAPID CITY, SD 57701-7351
(605) 343-7262
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20995
SD
101Y00000X
Counselor
PPC-1371
WY
Other
Enumeration date
08/11/2023
Last updated
06/05/2024
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