Individual
NANCY WISE-VANDERLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2412 S CLIFF AVE STE 200, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Mailing address
2412 S CLIFF AVE STE 200, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
378
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22161
SIOUX VALLEY HEALTH PLAN
SD
05
—
6551333
—
SD
Enumeration date
07/27/2005
Last updated
11/20/2017
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