Individual
CANDICE RADMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1032 S BRIDGEWAY PL, STE 100, EAGLE, ID 83616
(208) 246-0123
Mailing address
1032 S BRIDGEWAY PL, STE 100, EAGLE, ID 83616
(208) 246-0123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5051
ID
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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