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1396011284
MANDY TATE
POCATELLO, ID
NPI
1396011284
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-03-26
Last Update Date
2012-03-26
Business Address
-- MANDY TATE
2055 GARRETT WAY STE 1
POCATELLO, ID 83201-5100
Phone number: 208-233-7832
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Mailing Address
-- MANDY TATE
PO BOX 4908
POCATELLO, ID 83205-4908
Phone number: 208-236-1600
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