Individual
MR. BARRY R. REDFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
707 NORTH 7TH, STE #F, POCATELLO, ID 83201
(208) 424-3044
(208) 904-0494
Mailing address
707 NORTH 7TH, STE #F, POCATELLO, ID 83201
(208) 424-3044
(208) 904-0494
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW-35197
ID
104100000X
Social Worker
Primary
LMSW-26140
ID
Other
Enumeration date
10/26/2010
Last updated
06/11/2020
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