SearchIdaho101YM0800X

Tiffany Bascom, LCPC

NPI 1487701058 · on the registry since 2007

Practice

Address
2520 S 5th Ave
Pocatello, ID 83204
Phone
(208) 233-5433
Organisation at this address
Proactive Living, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Additional practice sites

  • 500 S 11th Ave, Pocatello, ID

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-12-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho