Individual
ANNE TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
409 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 234-2646
(208) 232-0035
Mailing address
409 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 234-2646
(208) 232-0035
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-4365
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808228800
—
ID
Enumeration date
07/29/2009
Last updated
07/29/2009
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