Individual
MRS. BRIANNE LYNN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
199 W BRIDGE ST, BLACKFOOT, ID 83221-2704
(208) 351-4058
Mailing address
693 E 700 N, FIRTH, ID 83236-1117
(208) 351-4058
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
Primary
LMSW-34773
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805932700
—
ID
Enumeration date
10/23/2017
Last updated
02/24/2026
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