Individual
BETTINA THROCKMORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S MAIN ST, POCATELLO, ID 83204-3210
(208) 232-8840
Mailing address
101 S MAIN ST, POCATELLO, ID 83204-3210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
9381804
ID
101YM0800X
Mental Health Counselor
Primary
9381804
ID
Other
Enumeration date
05/21/2026
Last updated
05/21/2026
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