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General NPI Number Information
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NPI Number | 1811391030
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Entity Type | Individual
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Provider Name | KELLY ERIN TOBIN CSW-PIP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 113 COMANCHE RD
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City | FORT MEADE
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State | SD
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Zip | 57741-1002
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Country | US
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Telephone | 605-720-7252
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Fax |
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Provider Business Mailing Address
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Address Line | 113 COMANCHE RD # 129
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City | FORT MEADE
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State | SD
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Zip | 57741-1002
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Country | US
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Telephone | 605-720-7058
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4701
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License Number State | SD
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