TIFFANY ANN BASCOM

POCATELLO, ID
NPI1487701058
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LCPC-3801)
Enumeration Date2007-01-04
Last Update Date2023-12-18
Business Address
TIFFANY ANN BASCOM LCPC
2520 S 5TH AVE
POCATELLO, ID 83204-1923
Phone number: 208-233-5433
Mailing Address
TIFFANY ANN BASCOM LCPC
2520 S 5TH AVE
POCATELLO, ID 83204-1923
Phone number: 208-233-5433
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