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1083623391
ANDREA L MASOM
MOSCOW, ID
NPI
1083623391
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LCPC#3017)
Enumeration Date
2006-08-05
Last Update Date
2007-07-08
Business Address
Ms. ANDREA L MASOM LCPC
106 E 3RD ST SUITE 2B
MOSCOW, ID 83843-2970
Phone number: 208-882-1289
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Mailing Address
Ms. ANDREA L MASOM LCPC
106 E 3RD ST SUITE 2B
MOSCOW, ID 83843-2970
Phone number: 208-882-1289
Copy
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