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General NPI Number Information
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NPI Number | 1962015339
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Entity Type | Organization
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Legal Business Name | READY FOR CHANGE, INC.
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 1373 FILLMORE ST
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City | TWIN FALLS
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State | ID
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Zip | 83301-3392
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Country | US
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Telephone | 208-737-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 322 E. MAIN ST. PMB 218
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City | BURLEY
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State | ID
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Zip | 83318-1933
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Country | US
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Telephone | 208-329-6647
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | SUSAN CHRISTINE BARRETT
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Credential | PSYD
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Telephone | 208-329-6647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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