Individual
LISA MICHELLE BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580
Mailing address
351 US 13-17 SOUTH, WINDSOR, NC 27983
(252) 794-4393
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20667
NC
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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