TIFFANIE DIANE LONG

POCATELLO, ID
NPI1205489234
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence:   LCPC-8664)
Enumeration Date2019-07-18
Last Update Date2023-07-06
Business Address
TIFFANIE DIANE LONG LCPC
13932 COYOTE GULCH
POCATELLO, ID 83202-5195
Phone number: 208-410-0100
Mailing Address
TIFFANIE DIANE LONG LCPC
13932 COYOTE GULCH
POCATELLO, ID 83202-5195
Phone number: 208-410-0100
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