Shirley Blanche Herbel, PHD

Individual provider Active NPI Clinical Psychologist · Fort Meade, SD

NPI 1497847958 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497847958
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
385 (SD)
Practice address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone
(605) 720-7000
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
385SDMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 385 SD Yes

Addresses

Primary practice location

113 Comanche Rd
Fort Meade, SD 57741-1002

Mailing address

113 Comanche Rd
Fort Meade, SD 57741-1002

Other names

  • Shirley Blanche Moen Former name

Other providers in Fort Meade, SD

All providers in Fort Meade, SD · Clinical Psychologist in South Dakota

Sources for this page

Verify at the official NPI Registry.