Individual
BLAISE LYNN REAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3625 5TH ST STE 100, RAPID CITY, SD 57701-6002
(605) 718-1095
Mailing address
3625 5TH ST STE 100, RAPID CITY, SD 57701-6002
(605) 718-1095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
87241516
ND
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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