| Sandbulte Inc | |
|
2210 W. Brown Place Sioux Falls SD 57105 | |
| (605) 332-1700 | |
| (605) 336-9031 |
| Full Name | Sandbulte Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2210 W. Brown Place, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Shelley L Sandbulte (OWNER-PSYCHOLOGIST) |
| Authorized Official Contact | 6053321700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandbulte Inc 2210 W Brown Place Sioux Falls SD 57105 Ph: (605) 332-1700 | Sandbulte Inc 2210 W. Brown Place Sioux Falls SD 57105 Ph: (605) 332-1700 |
| NPI Number | 1366563215 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366563215 | NPI | - | NPPES |
| 6550683 | Medicaid | SD | |
| 0004659 | Other | SD | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 311 (South Dakota) | Primary |
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