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Individual
LOUIS BEDOYA
Active
Individual
LOUIS BEDOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
7173970
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7173970
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
04/03/2019
Last updated
04/03/2019
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