Organization
BAMBI LASSEN, MSW, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAMBI R. LASSEN LCSW (CLINICIAN)
(208) 290-5592
Entity
Organization
Contact information
Practice address
102 S EUCLID AVE STE 111, SANDPOINT, ID 83864-4916
(208) 263-4477
(208) 263-4478
Mailing address
PO BOX 10, DOVER, ID 83825-0010
(208) 290-5592
(208) 263-4478
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
29490
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063581429
—
ID
Enumeration date
12/08/2017
Last updated
12/08/2017
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