Individual
STEPHANIE MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1001 N 7TH AVE STE 260, POCATELLO, ID 83201-5788
(208) 242-8249
(208) 242-9115
Mailing address
1001 N 7TH AVE STE 260, POCATELLO, ID 83201-5788
(208) 242-8249
(208) 242-9115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
TAXONOMY
ID
Enumeration date
12/03/2019
Last updated
12/03/2019
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