Individual
MRS. MARY LERAE HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12451 HWY 1806, MOBRIDGE, SD 57601
(605) 845-7181
(605) 845-5072
Mailing address
PO BOX 680, MOBRIDGE, SD 57601-0680
(605) 845-7181
(605) 845-5072
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
R029350
SD
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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