Healthcare Provider Details

I. General information

NPI: 1932038056
Provider Name (Legal Business Name): BAYLEE SANDBULTE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 S MINNESOTA AVE STE 10
SIOUX FALLS SD
57105-4746
US

IV. Provider business mailing address

210 W ELM ST APT 9
HARRISBURG SD
57032-2482
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-3464
  • Fax:
Mailing address:
  • Phone: 605-690-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: