Provider Information for 1225582182
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Miss JESSICA SHAFFER CSW-PIP
Sex: Female
NPI: 1225582182
Last Updated: 2016-08-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1225582182 | ||||||||
| Enumeration Date | 2016-08-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 187 OYATE CIR LOWER BRULE, SD 57548-8500 United States Phone: 605-208-0047 | Fax:605-473-8051 | ||||||||
| Primary Practice Address | 187 OYATE CIR LOWER BRULE, SD 57548-8500 United States Phone: 605-208-0047 | Fax:605-473-8051 | ||||||||
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