Provider Information for 1558997262
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MIKEA BARRIE LMSW
Sex: Female
NPI: 1558997262
Last Updated: 2020-03-14
Certification Date: 2020-03-14
Certification Date: 2020-03-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1558997262 | ||||||||
| Enumeration Date | 2020-03-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2051 15TH DR HEYBURN, ID 83336-9646 United States Phone: 208-431-6256 | Fax: | ||||||||
| Primary Practice Address | 707 F ST RUPERT, ID 83350-1638 United States Phone: 208-650-3977 | Fax: | ||||||||
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