Andrea L Masom is a Professional in Moscow, Idaho. Andrea L Masom practices all healthcare services and medical treatments related to Professional. The NPI Number for Andrea L Masom is 1083623391. The last update date is 2007-07-08.
Andrea L Masom's current location address is 106 E 3rd St, Moscow, Idaho. You can contact this provider via phone number 2088821289 and fax number 2088828406. The mailing address for Andrea L Masom is 106 E 3rd St, Moscow, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Andrea L Masom |
|---|---|
| Address | 106 E 3rd St, Moscow, Idaho |
| Phone Number | 2088821289 |
| Fax Number | 2088828406 |
| Sole Proprietor | Y |
| Credentials | LCPC |
NPI Number Detail
| NPI Number | 1083623391 |
|---|---|
| Provider Enumeration Date | 2006-08-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 106 E 3rd St |
|---|---|
| City | Moscow |
| State | Idaho (ID) |
| Post Code | 838432970 |
| Phone Number | 2088821289 |
| Fax Number | 2088828406 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | LCPC#3017 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| Q5977 | ID | BLUE CROSS |
Post Comment/ Review Below
What is the unique provider identifier assigned to Andrea L Masom?
The Andrea L Masom has been issued the NPI (National Provider Identifier) 1083623391 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Andrea L Masom's facilities are situated?
The facilities of Andrea L Masom are physically located at the following address: 106 E 3Rd St, Moscow, ID, 838432970.
What is the Andrea L Masom's specialty and taxonomy code?
The Andrea L Masom's specialty is Professional, and the corresponding taxonomy code is 101Yp2500X.
On what date did the Andrea L Masom receive its 1083623391 assignment from the Centers for Medicare & Medicaid Services?
The Andrea L Masom was assigned its 1083623391 by the Centers for Medicare & Medicaid Services on 2006-08-05.
As of what date were the Andrea L Masom's details last updated?
The information pertaining to the Andrea L Masom, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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