BRYSON KAY VAUGHAN

POCATELLO, ID
NPI1598192734
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  LPC-4103)
Enumeration Date2013-10-02
Last Update Date2013-10-02
Business Address
-- BRYSON KAY VAUGHAN LPC
110 S. 19TH AVE.
POCATELLO, ID 83201
Phone number: 208-234-4722
Mailing Address
-- BRYSON KAY VAUGHAN LPC
110 S 19TH AVE
POCATELLO, ID 83201-3312
Phone number: 208-234-4722