Individual
VINCENT MARASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 HOSPITAL WAY STE 477, POCATELLO, ID 83201-2744
(208) 233-7832
Mailing address
444 HOSPITAL WAY STE 477, POCATELLO, ID 83201-2744
(208) 233-7832
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6388
ID
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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