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1235376062
RENEE LYNN BOZORG-OMID
POCATELLO, ID
NPI
1235376062
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC 3249)
Enumeration Date
2009-01-15
Last Update Date
2009-01-15
Business Address
Dr. RENEE LYNN BOZORG-OMID LPC
500 S 11TH AVE STE 302
POCATELLO, ID 83201-4879
Phone number: 208-233-0150
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Mailing Address
Dr. RENEE LYNN BOZORG-OMID LPC
PO BOX 4455
POCATELLO, ID 83205-4455
Phone number: 912-660-2674
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