| Organization Name: | MARK W. PERRENOUD PH.D. INC. |
| NPI Number: | 1013283670 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK WILLIAM PERRENOUD (PRESIDENT) |
| Mailing Address: | 1818 West Fulton Suite 201 Rapid City |
| State: | SD US |
| Postal Code: | 577024347 |
| Phone Number: | 6053486500 |
| Fax Number: | 6053417409 |
| NPI Enumeration Date: | 03/28/2012 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |