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Individual

SOMER BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3522 BRIAR CREEK LN, AMMON, ID 83406-4728
(208) 529-1660
Mailing address
3522 BRIAR CREEK LN, AMMON, ID 83406-4728
(208) 529-1660

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-6841
ID
101YM0800X
Mental Health Counselor
LPC-6385
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518409382
ID
05
26-3016352
ID
Enumeration date
11/10/2016
Last updated
02/19/2019
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