Individual
MS. CAROL MANDERSCHEID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.PC
Contact information
Practice address
284 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 733-7186
(208) 733-7178
Mailing address
284 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 733-7186
(208) 733-7178
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-4411
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-4411
IDAHO BUREAU OF OCCUPATIONAL LICENSES
ID
Enumeration date
01/12/2011
Last updated
01/12/2011
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