Doctor Name: | MRS. BAMBI LASSEN |
NPI Number: | 1063581429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | LMSW-26244 |
Business Practice Address: | 1215 Michigan Street Ste C Sandpoint, ID - 83864 |
Business Phone Number: | 2082638948 |
Business Fax Number: | |
Mailing Address: | 1215 Michigan Street, Ste C SANDPOINT |
State: | ID |
Postal Code: | 83864 |
Phone Number: | 2082638948 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LMSW-26244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |