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General NPI Number Information
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NPI Number | 1437280294
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Entity Type | Organization
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Legal Business Name | NATIVE AMERICAN ADVOCACY PROGRAM
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 302 EAST 2ND STREET
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City | WINNER
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State | SD
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Zip | 57580-1831
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Country | US
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Telephone | 605-842-3977
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Fax | 605-842-3983
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Provider Business Mailing Address
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Address Line | PO BOX 527
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City | WINNER
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State | SD
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Zip | 57580-0527
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Country | US
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Telephone | 605-842-3977
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Fax | 605-842-3983
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MARLA C BULL BEAR
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Credential | MA
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Telephone | 605-842-3977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | SDCL 34-20A-27
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License Number State | SD
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