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General NPI Number Information
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NPI Number | 1376230037
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Entity Type | Individual
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Provider Name | AFTON GRADY-WINEBRINNER
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Gender | Female
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1028 WALNUT ST
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City | YANKTON
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State | SD
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Zip | 57078-2910
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Country | US
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Telephone | 605-665-4606
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Fax | 605-665-4673
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Provider Business Mailing Address
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Address Line | 1028 WALNUT ST
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City | YANKTON
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State | SD
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Zip | 57078-2910
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Country | US
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Telephone | 605-665-4606
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Fax | 605-665-4673
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6701
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 129102
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License Number State | IA
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