person
Tiffany Ann Bascom, LCPC
Mental Health Counselor in Pocatello, Idaho
NPI 1487701058

Tiffany Ann Bascom is a Mental Health Counselor based in Pocatello, ID and is specialized in Mental Health. Tiffany Ann Bascom practices in Pocatello, ID and has the professional credentials of LCPC. The NPI Number for Tiffany Ann Bascom is 1487701058 and holds a License No. LCPC-3801 (Idaho).

The current practice location address for Tiffany Ann Bascom is 2520 S 5Th Ave, Pocatello, ID and can be reached out via phone at 208-233-5433.

Location: 2520 S 5Th Ave, Pocatello, ID, 83204-1923
person
Provider Profile Details
NPI Number
1487701058
Provider Name
Tiffany Ann Bascom
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
2520 S 5Th Ave, Pocatello, ID, 83204-1923
Phone Number
208-233-5433
Fax Number
Provider Enumeration Date
01/04/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2520 S 5Th Ave
City
State
Zip
83204-1923
Phone Number
208-233-5433
Fax Number
person
Provider Business Mailing Address Details
Address
2520 S 5Th Ave
City
State
Zip
83204-1923
Phone Number
208-233-5433
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LCPC-3801 (Idaho)
Definition
Definition to come...
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