Individual
MIKEA BARRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
707 F ST, RUPERT, ID 83350-1638
(208) 650-3977
Mailing address
2051 15TH DR, HEYBURN, ID 83336-9646
(208) 431-6256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-39345
ID
Other
Enumeration date
03/14/2020
Last updated
03/14/2020
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