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Individual

MARILYN STANDFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1202 E 25TH ST, IDAHO FALLS, ID 83404-7072
(208) 520-8219
Mailing address
1202 E 25TH ST, IDAHO FALLS, ID 83404-7072
(208) 520-8219

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
171M00000X
Case Manager/Care Coordinator
Primary
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor

Other

Enumeration date
07/29/2013
Last updated
08/09/2013
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