Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WAKIYAN PETA, LAC
Active Sole ProprietorWAKIYAN PETA, LAC is a Addiction (Substance Use Disorder) Counselor healthcare provider located in EAGLE BUTTE, South Dakota. NPI 1043090822 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · EAGLE BUTTE, SD
Registration Details
- NPI Number
- 1043090822
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 29, 2023 (2.8339594264843 yrs)
- Last Updated
- Sep 29, 2023
- License
-
7051316 (SD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
24276 166TH STEAGLE BUTTE, SD, 576258141Browse SD providers · Browse ZIP 57625
- Phone
- 6059640722
- Fax
- 6059648905
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.