Brom Glidden, M.A.
Counselor, Mental Health in Sandpoint, ID. Individual provider (NPI-1).
NPI number1154694792
StatusActive
Last updated in NPPESFeb 13, 2012
Details
- NPI
- 1154694792
- Entity type
- Individual (NPI-1)
- Name
- Brom Glidden
- Credential
- M.A.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 13, 2012
- Last updated
- Feb 13, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | LCP-4881 | ID | Yes |
Practice location
534 N Center Valley RdSandpoint, ID 83864-7148
Phone 208-597-0994
Mailing address
534 N Center Valley RdSandpoint, ID 83864-7148
Phone 208-597-0994
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