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Individual
MARK BEZANSON
Active
Individual
MARK BEZANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1019412
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7706655Y0NH01
BHN
NH
05
—
99003227
—
NH
Enumeration date
11/17/2006
Last updated
10/11/2017
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