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1578789392
STACI J. BRISCOE
POCATELLO, ID
NPI
1578789392
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: ID LSW27082)
Enumeration Date
2007-04-18
Last Update Date
2007-07-08
Business Address
-- STACI J. BRISCOE LSW
2055 GARRETT WAY SUITE 1
POCATELLO, ID 83201-5100
Phone number: 208-233-7832
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Mailing Address
-- STACI J. BRISCOE LSW
PO BOX 4908
POCATELLO, ID 83205-4908
Phone number: 208-236-1600
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