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Ms. Andrea L Masom, LCPC
Professional Counselor in Moscow, Idaho
NPI 1083623391

Andrea L Masom is a Professional Counselor based in Moscow, ID and is specialized in Professional. Andrea L Masom practices in Moscow, ID and has the professional credentials of LCPC. The NPI Number for Andrea L Masom is 1083623391 and holds a License No. LCPC#3017 (Idaho).

The current practice location address for Andrea L Masom is 106 E 3Rd St, Moscow, ID and can be reached out via phone at 208-882-1289 and via fax at 208-882-8406.

Location: 106 E 3Rd St, Moscow, ID, 83843-2970
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083623391
Provider Name
Andrea L Masom
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
106 E 3Rd St, Moscow, ID, 83843-2970
Phone Number
208-882-1289
Fax Number
208-882-8406
Provider Enumeration Date
08/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q5977 01 ID BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
106 E 3Rd St
City
Moscow
State
Idaho
Zip
83843-2970
Phone Number
208-882-1289
Fax Number
208-882-8406
person
Provider Business Mailing Address Details
Address
106 E 3Rd St
City
Moscow
State
Idaho
Zip
83843-2970
Phone Number
208-882-1289
Fax Number
208-882-8406
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
LCPC#3017 (Idaho)
Definition
Definition to come...
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