Tomazin, Kathleen S
Tomazin, Kathleen S is an sole proprietor health care provider with primary practice located at 90 W Judicial St , Blackfoot ID 83221-2715. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Tomazin, Kathleen S can be contacted via phone (208) 782-2060.Contact Information
Primary practice address
90 W Judicial St
Blackfoot ID 83221-2715
Phone: (208) 782-2060
Fax: (208) 782-0209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LCPC 332 | Idaho |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | LSW 1810 | Idaho |
Profile Details
| NPI number | 1194942185 |
|---|---|
| LBN Legal business name | Tomazin, Kathleen S |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1194942185 | NPPES |
| Idaho | MEDICAID | 80662262 | |
| Idaho | MEDICAID | 8059327 |
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