TIFFANY ANN BASCOM LCPC
Individual Provider (NPI-1)
Active
Counselor, Mental Health
Provider Information
- NPI Number
1487701058- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LCPC
- Status
- Active
Contact & Location
- Address
- 2520 S 5TH AVE, POCATELLO, ID, 832041923
- Phone
- (208) 233-5433
Specialties & Taxonomies
Counselor, Mental Health
Primary License: ID #LCPC-3801