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1992140214
CANDACE L BARRY
CHUBBUCK, ID
NPI
1992140214
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2013-04-30
Last Update Date
2013-04-30
Business Address
CANDACE L BARRY
4460 CENTRAL WAY STE 2
CHUBBUCK, ID 83202-5095
Phone number: 208-237-1711
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Mailing Address
CANDACE L BARRY
PO BOX 4908
POCATELLO, ID 83205-4908
Phone number: 208-237-1711
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