Individual
LETTIE STRADLEY-BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-8478
Contact information
Practice address
9915 N 26TH E, IDAHO FALLS, ID 83401-6435
(208) 521-8389
(208) 271-8882
Mailing address
9915 N 26TH E, IDAHO FALLS, ID 83401-6435
(208) 201-4510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7198
ID
Other
Enumeration date
09/10/2019
Last updated
06/05/2023
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