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NPI Code Detail

MEDICARE: ANITA RUTH HARTL CSW-PIP

MEDICARE: ANITA RUTH HARTL CSW-PIP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker3304SD

General Provider Information

NPI Number : 1538461371
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA RUTH HARTL CSW-PIP
Provider Business Mailing Address
First Line : 2165 PROMISE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-8981
Country : US
Telephone Number : 605-718-1095
Fax Number : 612-725-1315
Provider Business Practice Location Address
First Line : 2165 PROMISE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-8981
Country : US
Telephone Number : 605-718-1095
Fax Number : 612-725-1315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2010
Last Update Date : 03/26/2024

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