Individual
TAMARA S WIRTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 791-7400
(605) 791-7401
Mailing address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 791-7400
(605) 791-7401
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12128886
SD
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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