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Organization

FOUR RIVERS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LINDA K. VANDE WEERD LMFT,LPC-MH,QMHP (OWNER/CLINICAL THERAPIST)
(605) 692-6444
Entity
Organization

Contact information

Practice address
922 4TH ST, SUITE A, BROOKINGS, SD 57006-2173
(605) 692-6444
(605) 692-8997
Mailing address
922 4TH ST, SUITE A, BROOKINGS, SD 57006-2173
(605) 692-6444
(605) 692-8997

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6575272
SD
Enumeration date
06/11/2015
Last updated
06/26/2015
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