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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801307418 | NPPES |
| Idaho | MEDICAID | 805932700 |
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