Individual
BROM GLIDDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
534 N CENTER VALLEY RD, SANDPOINT, ID 83864-7148
(208) 597-0994
Mailing address
534 N CENTER VALLEY RD, SANDPOINT, ID 83864-7148
(208) 597-0994
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCP-4881
ID
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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