Individual
MS. BROOKE EARIN SJOSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
250 NORTHWEST BLVD STE 101A, COEUR D ALENE, ID 83814-2971
(208) 691-1174
(208) 247-8513
Mailing address
PO BOX 129, LIBERTY LAKE, WA 99019-0129
(208) 691-1174
(208) 247-8513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4347
ID
101YM0800X
Mental Health Counselor
LH00007832
WA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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