Individual
MS. TANYA R FORSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC
Contact information
Practice address
275 SOUTH 5TH AVE, SUITE 155, POCATELLO, ID 83201
(208) 232-2506
(208) 478-9558
Mailing address
275 SOUTH 5TH AVE, SUITE 155, POCATELLO, ID 83201
(208) 232-2506
(208) 478-9558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
187
ID
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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