| Ms Kristy Lee Broncho, LCSW | |
|
Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | |
| (208) 237-5631 | |
| (208) 237-5796 |
| Full Name | Ms Kristy Lee Broncho |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | Mission Road Blding 248, Fort Hall, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932323045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-24506 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Kristy Lee Broncho, LCSW Rr 6 Box 918, Pocatello, ID 83202-9549 Ph: (208) 637-8032 | Ms Kristy Lee Broncho, LCSW Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Ph: (208) 237-5631 |
Akaila Martin, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 N Mission Road #240, Fort Hall, ID 83203 Phone: 208-478-4026 Fax: 208-478-4022 | |
Mr. Thayne Andersen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 | |
Daniel Jerome Hall, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 | |
Ms. Shari L. Newsome, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Mission Road Building 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 | |
Jessie A Bacon, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 | |
Matthew J Wadsworth, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 |