Healthcare Provider Details

I. General information

NPI: 1154659464
Provider Name (Legal Business Name): DOREEN J. RONNING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOREEN J RONNING

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 W 23RD ST STE 101 HEARTLAND PSYCHOLOGICAL SERVICES
YANKTON SD
57078
US

IV. Provider business mailing address

904 W 23RD ST STE 101 HEARTLAND PSYCHOLOGICAL SERVICES
YANKTON SD
57078
US

V. Phone/Fax

Practice location:
  • Phone: 605-665-0841
  • Fax: 605-665-0096
Mailing address:
  • Phone: 605-665-0841
  • Fax: 605-665-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC828
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: