Larson, Brianne Lynn

Larson, Brianne Lynn is an individual health care provider with primary practice located at 199 W Bridge St , Blackfoot ID 83221-2704. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Larson, Brianne Lynn can be contacted via phone (208) 351-4058.

Contact Information

Primary practice address
199 W Bridge St Blackfoot ID 83221-2704
Phone: (208) 351-4058
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1801307418
LBN Legal business name Larson, Brianne Lynn
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2017
Last updated Jun 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801307418 NPPES
Idaho MEDICAID 805932700

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