Individual
MARK VENTRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, QMHP
Contact information
Practice address
350 ELK ST, RAPID CITY, SD 57701-7351
(605) 343-7262
(605) 343-7293
Mailing address
840 STATE ST, SPEARFISH, SD 57783-2140
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT1159
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4997408
BLUE CROSS/BLUE SHIELD
SD
Enumeration date
03/16/2007
Last updated
11/07/2007
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