| Doctor Name: | MRS. KATHLEEN S TOMAZIN |
| NPI Number: | 1194942185 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | LCPC 332 |
| Business Practice Address: | 90 W Judicial St Blackfoot, ID - 832212715 |
| Business Phone Number: | 2087822060 |
| Business Fax Number: | 2087820209 |
| Mailing Address: | 90 W Judicial St, BLACKFOOT |
| State: | ID |
| Postal Code: | 832212715 |
| Phone Number: | 2087822060 |
| Fax Number: | 2087820209 |
| NPI Enumeration Date: | 04/19/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LCPC 332 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |