| Broncho Mental Health | |
|
772 E Ross Fork Road #41 Pocatello ID 83202 | |
| (208) 220-7520 | |
| Not Available |
| Full Name | Broncho Mental Health |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 772 E Ross Fork Road #41, Pocatello, Idaho |
| Authorized Official Name and Position | Krissy L Broncho (PRESIDENT) |
| Authorized Official Contact | 2082207520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broncho Mental Health 772 E Ross Fork Road #41 Pocatello ID 83202 Ph: (208) 220-7520 | Broncho Mental Health 772 E Ross Fork Road #41 Pocatello ID 83202 Ph: (208) 220-7520 |
| NPI Number | 1023702362 |
|---|---|
| Provider Enumeration Date | 06/08/2023 |
| Last Update Date | 06/08/2023 |
| Certification Date | 06/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023702362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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