Provider Information for 1386029460
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Mrs. MICHELLE ANNE PLISKA NCC, LPC, QMHP
Sex: Female
NPI: 1386029460
Last Updated: 2022-10-03
Certification Date: 2022-10-02
Certification Date: 2022-10-02
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386029460 | ||||||||||||
| Enumeration Date | 2015-07-30 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 600 N TAMARAC AVE BRANDON, SD 57005 United States Phone: 605-940-2844 | Fax: | ||||||||||||
| Primary Practice Address | 1500 S SYCAMORE AVE STE 102 SIOUX FALLS, SD 57110-3711 United States Phone: 605-223-5155 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 5621 SOUTHEASTERN AVE | ||||||||||||
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