Provider Demographics
NPI:1003593229
Name:SCHWEITZER, MARY (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLACK HAWK
Mailing Address - State:SD
Mailing Address - Zip Code:57718-8101
Mailing Address - Country:US
Mailing Address - Phone:605-390-3700
Mailing Address - Fax:
Practice Address - Street 1:528 KANSAS CITY ST STE 5
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5037
Practice Address - Country:US
Practice Address - Phone:605-299-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health