Healthcare Provider Details

I. General information

NPI: 1346262649
Provider Name (Legal Business Name): KATHY J SAZAMA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S EUCLID AVE SUITE 201 MBII
SIOUX FALLS SD
57105-7700
US

IV. Provider business mailing address

1201 S EUCLID AVE SUITE 201 MBII
SIOUX FALLS SD
57105-7700
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-7590
  • Fax: 605-328-7596
Mailing address:
  • Phone: 605-328-7590
  • Fax: 605-328-7596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberSDLMFT 1000
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: